Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.13 / $275.01 / $9,504.00	Facility		$71.13	$275.01	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.75 / $76.73 / $135.27	Professional		$44.75	$76.73	$135.27
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.38 / $35.57 / $61.50	Professional	52	$22.38	$35.57	$61.50
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $8.94 / $14.23 / $24.60	Professional	53	$8.94	$14.23	$24.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $53.27 / $53.27 / $62.67	Professional		$53.27	$53.27	$62.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.83 / $69.30 / $118.40	Professional		$41.83	$69.30	$118.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.82 / $52.58 / $65.09	Facility		$43.82	$52.58	$65.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.76 / $75.76 / $82.27	Professional		$75.76	$75.76	$82.27
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 $53.46 / $84.13 / $136.32	Professional		$53.46	$84.13	$136.32
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $213.29 / $254.86 / $539.66	Facility		$213.29	$254.86	$539.66
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $54.77 / $86.08 / $141.44	Professional		$54.77	$86.08	$141.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.12 / $78.33 / $105.09	Professional		$58.12	$78.33	$105.09
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $979.00 / $3,218.00	Facility		$444.00	$979.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $63.79 / $92.70 / $166.35	Professional		$63.79	$92.70	$166.35