Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.33 / $2,547.00 / $10,635.00	Facility		$84.33	$2,547.00	$10,635.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $28.36 / $42.16 / $140.76	Facility	52	$28.36	$42.16	$140.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.19 / $66.06 / $177.74	Professional		$53.19	$66.06	$177.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $1,981.00 / $3,943.00	Facility		$814.00	$1,981.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.18 / $159.11 / $243.13	Professional		$77.18	$159.11	$243.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.74 / $74.09 / $91.71	Facility		$57.74	$74.09	$91.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.93 / $88.30 / $127,498.73	Professional		$67.93	$88.30	$127,498.73
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 $64.84 / $95.71 / $208.88	Professional		$64.84	$95.71	$208.88
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $72.65 / $72.65 / $72.65	Facility		$72.65	$72.65	$72.65
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $56.37 / $56.37 / $56.37	Facility	52	$56.37	$56.37	$56.37
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $95.71 / $208.88	Professional		$67.40	$95.71	$208.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.68 / $72.25 / $101.47	Professional		$54.68	$72.25	$101.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,940.00 / $4,067.00	Facility		$1,020.00	$1,940.00	$4,067.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.38 / $90.90 / $172.58	Professional		$54.38	$90.90	$172.58