Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $684.78 / $3,602.00 / $10,268.00	Facility		$684.78	$3,602.00	$10,268.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,999.48 / $3,915.83 / $3,915.83	Facility	50	$2,999.48	$3,915.83	$3,915.83
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $100.02 / $424.39 / $1,284.33	Facility	52	$100.02	$424.39	$1,284.33
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $40.01 / $169.76 / $513.73	Facility	53	$40.01	$169.76	$513.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.04 / $684.78 / $1,472.17	Professional		$200.04	$684.78	$1,472.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.19 / $190.19 / $370.88	Professional		$190.19	$190.19	$370.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,786.00 / $8,800.00	Facility		$1,145.00	$2,786.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $266.74 / $801.20 / $1,373.56	Professional		$266.74	$801.20	$1,373.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $190.19 / $228.23 / $356.61	Facility		$190.19	$228.23	$356.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $860.10 / $953.99 / $1,524.72	Professional		$860.10	$953.99	$1,524.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.53 / $437.45 / $1,458.79	Professional		$225.53	$437.45	$1,458.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,033.34 / $3,033.34 / $3,593.70	Facility		$3,033.34	$3,033.34	$3,593.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $228.23 / $445.76 / $1,467.47	Professional		$228.23	$445.76	$1,467.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $737.77 / $1,003.12 / $1,375.22	Professional		$737.77	$1,003.12	$1,375.22
United Facility/Professional Facility Modifier Low / Median / High Price $2,233.00 / $4,383.00 / $6,522.00	Facility		$2,233.00	$4,383.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $796.76 / $1,092.88 / $1,852.59	Professional		$796.76	$1,092.88	$1,852.59