Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $753.46 / $2,124.02 / $9,504.00	Facility		$753.46	$2,124.02	$9,504.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $447.81 / $763.91 / $1,624.84	Facility	54	$447.81	$763.91	$1,624.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.01 / $684.96 / $1,208.69	Professional		$562.01	$684.96	$1,208.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,190.08 / $1,190.08 / $1,432.98	Professional	50	$1,190.08	$1,190.08	$1,432.98
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $431.80 / $513.72 / $906.52	Professional	54	$431.80	$513.72	$906.52
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $86.36 / $102.74 / $181.30	Professional	55	$86.36	$102.74	$181.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $615.48 / $615.48 / $684.54	Professional		$615.48	$615.48	$684.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,722.00 / $8,800.00	Facility		$1,145.00	$2,722.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $437.49 / $629.66 / $1,166.53	Professional		$437.49	$629.66	$1,166.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $656.23 / $944.50 / $1,749.79	Professional	50	$656.23	$944.50	$1,749.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $623.19 / $882.12 / $1,079.31	Facility		$623.19	$882.12	$1,079.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $504.96 / $789.48 / $1,231.58	Professional		$504.96	$789.48	$1,231.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $459.12 / $511.97 / $21,571.00	Facility		$459.12	$511.97	$21,571.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $695.92 / $695.92 / $695.92	Facility	54	$695.92	$695.92	$695.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $539.09 / $783.32 / $1,368.72	Professional		$539.09	$783.32	$1,368.72
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $459.12 / $511.97 / $1,679.97	Facility		$459.12	$511.97	$1,679.97
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $539.09 / $802.56 / $1,250.44	Professional		$539.09	$802.56	$1,250.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.13 / $476.54 / $854.21	Professional		$76.13	$476.54	$854.21
United Facility/Professional Facility Modifier Low / Median / High Price $1,368.00 / $2,474.00 / $4,951.00	Facility		$1,368.00	$2,474.00	$4,951.00
United Facility/Professional Professional Modifier Low / Median / High Price $563.48 / $738.18 / $1,454.01	Professional		$563.48	$738.18	$1,454.01