Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $547.97 / $4,004.40 / $8,553.00	Facility		$547.97	$4,004.40	$8,553.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,775.12 / $1,807.27 / $3,983.00	Facility	50	$1,775.12	$1,807.27	$3,983.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $149.72 / $222.63 / $501.10	Facility	52	$149.72	$222.63	$501.10
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.89 / $89.05 / $200.44	Facility	53	$59.89	$89.05	$200.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.44 / $397.97 / $648.00	Professional		$299.44	$397.97	$648.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,048.04 / $1,048.04 / $1,048.04	Professional		$1,048.04	$1,048.04	$1,048.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,152.00 / $3,025.00 / $8,800.00	Facility		$1,152.00	$3,025.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.25 / $340.37 / $612.64	Professional		$259.25	$340.37	$612.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $284.27 / $341.12 / $422.22	Facility		$284.27	$341.12	$422.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $312.70 / $312.70 / $353.85	Professional		$312.70	$312.70	$353.85
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 $262.10 / $406.34 / $612.79	Professional		$262.10	$406.34	$612.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,356.60 / $2,384.62 / $4,165.28	Facility		$1,356.60	$2,384.62	$4,165.28
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $284.27 / $436.35 / $596.97	Professional		$284.27	$436.35	$596.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $299.23 / $398.26 / $531.79	Professional		$299.23	$398.26	$531.79
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 $291.74 / $392.93 / $672.53	Professional		$291.74	$392.93	$672.53