Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $360.50 / $2,565.00 / $9,496.00	Facility		$360.50	$2,565.00	$9,496.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,722.50 / $1,722.50 / $1,722.50	Facility	52	$1,722.50	$1,722.50	$1,722.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.00 / $682.14 / $1,203.01	Professional		$197.00	$682.14	$1,203.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $345.93 / $345.93 / $345.93	Professional		$345.93	$345.93	$345.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $918.00 / $2,114.00 / $8,800.00	Facility		$918.00	$2,114.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $242.63 / $707.50 / $1,881.46	Professional		$242.63	$707.50	$1,881.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.07 / $228.08 / $282.30	Facility		$190.07	$228.08	$282.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $237.59 / $788.98 / $932.43	Professional		$237.59	$788.98	$932.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $343.38 / $581.00 / $1,758.30	Facility		$343.38	$581.00	$1,758.30
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $274.70 / $274.70 / $274.70	Facility	52	$274.70	$274.70	$274.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $68.68 / $68.68 / $68.68	Facility	53	$68.68	$68.68	$68.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.58 / $433.47 / $1,509.19	Professional		$218.58	$433.47	$1,509.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $581.00 / $1,309.85	Facility		$400.00	$581.00	$1,309.85
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $274.70 / $274.70 / $274.70	Facility	52	$274.70	$274.70	$274.70
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $68.68 / $68.68 / $68.68	Facility	53	$68.68	$68.68	$68.68
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $224.23 / $437.17 / $1,509.19	Professional		$224.23	$437.17	$1,509.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $717.75 / $1,095.29	Professional		$69.00	$717.75	$1,095.29
United Facility/Professional Facility Modifier Low / Median / High Price $675.00 / $2,499.00 / $5,235.00	Facility		$675.00	$2,499.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $801.00 / $1,106.06 / $1,813.68	Professional		$801.00	$1,106.06	$1,813.68