Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.19 / $494.44 / $3,847.00	Facility		$97.19	$494.44	$3,847.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $33.15 / $121.48 / $327.12	Facility	52	$33.15	$121.48	$327.12
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $12.34 / $22.22 / $59.37	Facility	53	$12.34	$22.22	$59.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.71 / $117.25 / $262.95	Professional		$61.71	$117.25	$262.95
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.86 / $48.60 / $94.52	Professional	52	$30.86	$48.60	$94.52
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $12.34 / $19.44 / $39.58	Professional	53	$12.34	$19.44	$39.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $98.78 / $102.73	Professional		$77.95	$98.78	$102.73
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $26.73 / $26.73 / $26.73	Professional	52	$26.73	$26.73	$26.73
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $84.60 / $84.60 / $84.60	Professional	53	$84.60	$84.60	$84.60
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 $69.98 / $110.79 / $186.79	Professional		$69.98	$110.79	$186.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.97 / $74.95 / $89.07	Facility		$59.97	$74.95	$89.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.27 / $120.86 / $214.19	Professional		$102.27	$120.86	$214.19
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 $74.36 / $121.49 / $200.43	Professional		$74.36	$121.49	$200.43
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $129.41 / $281.33 / $436.41	Facility		$129.41	$281.33	$436.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $74.95 / $128.15 / $200.43	Professional		$74.95	$128.15	$200.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $86.01 / $115.47 / $157.15	Professional		$86.01	$115.47	$157.15
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 $90.97 / $128.33 / $204.18	Professional		$90.97	$128.33	$204.18