Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $657.65 / $5,467.00 / $11,143.00	Facility		$657.65	$5,467.00	$11,143.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $355.68 / $623.69 / $1,558.64	Facility	54	$355.68	$623.69	$1,558.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $412.35 / $627.99 / $1,198.23	Professional		$412.35	$627.99	$1,198.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $429.73 / $544.00 / $616.21	Professional		$429.73	$544.00	$616.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,152.00 / $2,897.00 / $8,800.00	Facility		$1,152.00	$2,897.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $397.80 / $566.80 / $1,098.72	Professional		$397.80	$566.80	$1,098.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $572.20 / $701.49 / $1,289.18	Facility		$572.20	$701.49	$1,289.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $484.90 / $752.41 / $1,173.77	Professional		$484.90	$752.41	$1,173.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $790.70 / $949.77 / $21,571.00	Facility		$790.70	$949.77	$21,571.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $553.49 / $553.49 / $553.49	Facility	54	$553.49	$553.49	$553.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $441.04 / $668.87 / $1,218.53	Professional		$441.04	$668.87	$1,218.53
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $949.77 / $949.77 / $1,059.09	Facility		$949.77	$949.77	$1,059.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $462.16 / $702.35 / $1,093.26	Professional		$462.16	$702.35	$1,093.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.18 / $442.11 / $780.56	Professional		$76.18	$442.11	$780.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $4,072.00 / $6,522.00	Facility		$1,981.00	$4,072.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $559.28 / $747.53 / $1,507.19	Professional		$559.28	$747.53	$1,507.19