Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $2,137.96 / $6,606.93	Facility		$144.54	$2,137.96	$6,606.93
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Facility	22	$2,290.87	$2,290.87	$2,290.87
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility	53	$2,089.30	$2,089.30	$2,089.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $223.87 / $616.60	Professional		$79.43	$223.87	$616.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.71 / $85.11 / $363.08	Professional	52	$45.71	$85.11	$363.08
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $21.38 / $34.67 / $134.90	Professional	53	$21.38	$34.67	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $162.18 / $331.13	Professional		$75.86	$162.18	$331.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,995.26 / $3,981.07	Facility		$707.95	$1,995.26	$3,981.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $199.53 / $331.13	Professional		$95.50	$199.53	$331.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $91.20 / $104.71	Facility		$75.86	$91.20	$104.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $269.15 / $467.74	Professional		$239.88	$269.15	$467.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $204.17 / $21,379.62	Facility		$67.61	$204.17	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $199.53 / $380.19	Professional		$91.20	$199.53	$380.19
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $1,584.89 / $3,630.78	Facility		$660.69	$1,584.89	$3,630.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $218.78 / $380.19	Professional		$89.13	$218.78	$380.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $48.98	Professional		$32.36	$33.11	$48.98
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $851.14	Facility		$100.00	$100.00	$851.14
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $213.80 / $346.74	Professional		$77.62	$213.80	$346.74
United Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $1,862.09 / $4,073.80	Facility		$954.99	$1,862.09	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $177.83 / $331.13	Professional		$83.18	$177.83	$331.13