Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $1,949.84 / $9,549.93	Facility		$141.25	$1,949.84	$9,549.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $186.21 / $467.74	Professional		$79.43	$186.21	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $141.25	Professional		$70.79	$100.00	$141.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $186.21	Professional		$77.62	$109.65	$186.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $21,379.62	Facility		$141.25	$141.25	$21,379.62
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.18 / $28.18 / $28.18	Facility	53	$28.18	$28.18	$28.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $177.83 / $371.54	Professional		$91.20	$177.83	$371.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $602.56 / $21,379.62	Facility		$34.67	$602.56	$21,379.62
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $28.18 / $28.18 / $28.18	Facility	53	$28.18	$28.18	$28.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $169.82 / $338.84	Professional		$89.13	$169.82	$338.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $177.83 / $398.11	Professional		$77.62	$177.83	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $954.99 / $3,019.95	Facility		$316.23	$954.99	$3,019.95
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $186.21 / $338.84	Professional		$89.13	$186.21	$338.84