Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,055.87 / $7,350.00 / $11,627.00	Facility		$2,055.87	$7,350.00	$11,627.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $879.58 / $1,307.93 / $2,842.86	Facility	54	$879.58	$1,307.93	$2,842.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $992.21 / $1,175.80 / $3,790.48	Professional		$992.21	$1,175.80	$3,790.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,002.54 / $1,002.54 / $1,069.42	Professional		$1,002.54	$1,002.54	$1,069.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,084.00 / $4,426.00 / $19,117.00	Facility		$2,084.00	$4,426.00	$19,117.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $876.02 / $1,189.18 / $2,109.79	Professional		$876.02	$1,189.18	$2,109.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,412.39 / $1,731.53 / $2,631.55	Facility		$1,412.39	$1,731.53	$2,631.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,126.80 / $1,358.06 / $2,118.59	Professional		$1,126.80	$1,358.06	$2,118.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,311.10 / $1,938.72 / $21,571.00	Facility		$1,311.10	$1,938.72	$21,571.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $913.68 / $913.68 / $913.68	Facility	54	$913.68	$913.68	$913.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $978.32 / $1,503.06 / $2,328.05	Professional		$978.32	$1,503.06	$2,328.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,938.72 / $2,161.90 / $2,924.31	Facility		$1,938.72	$2,161.90	$2,924.31
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $987.66 / $1,521.03 / $2,193.65	Professional		$987.66	$1,521.03	$2,193.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.78 / $852.70 / $1,417.71	Professional		$151.78	$852.70	$1,417.71
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $6,392.00 / $11,276.00	Facility		$2,912.00	$6,392.00	$11,276.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,002.77 / $1,277.91 / $2,563.35	Professional		$1,002.77	$1,277.91	$2,563.35