Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $267.42 / $1,828.25 / $8,553.00	Facility		$267.42	$1,828.25	$8,553.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $762.86 / $2,898.96 / $3,362.84	Facility	50	$762.86	$2,898.96	$3,362.84
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $163.41 / $271.13 / $588.27	Facility	54	$163.41	$271.13	$588.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.27 / $296.17 / $617.00	Professional		$204.27	$296.17	$617.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $495.92 / $637.44 / $762.86	Professional	50	$495.92	$637.44	$762.86
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $153.19 / $193.92 / $499.64	Professional	54	$153.19	$193.92	$499.64
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $30.64 / $36.47 / $64.75	Professional	55	$30.64	$36.47	$64.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $196.19 / $232.31 / $313.27	Professional		$196.19	$232.31	$313.27
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $348.46 / $348.46 / $348.46	Professional	50	$348.46	$348.46	$348.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.01 / $305.13 / $577.94	Professional		$234.01	$305.13	$577.94
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $351.01 / $457.70 / $866.92	Professional	50	$351.01	$457.70	$866.92
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $252.86 / $252.86 / $252.86	Professional		$252.86	$252.86	$252.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $189.00 / $236.25 / $283.50	Facility		$189.00	$236.25	$283.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $223.77 / $279.70 / $368.53	Professional		$223.77	$279.70	$368.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.97 / $134.90 / $21,571.00	Facility		$120.97	$134.90	$21,571.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $238.23 / $238.23 / $238.23	Facility	54	$238.23	$238.23	$238.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.20 / $306.51 / $604.58	Professional		$195.20	$306.51	$604.58
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $120.97 / $317.00 / $992.48	Facility		$120.97	$317.00	$992.48
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $200.37 / $313.27 / $539.07	Professional		$200.37	$313.27	$539.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $154.67 / $223.66 / $323.66	Professional		$154.67	$223.66	$323.66
United Facility/Professional Facility Modifier Low / Median / High Price $745.00 / $1,848.00 / $3,923.00	Facility		$745.00	$1,848.00	$3,923.00
United Facility/Professional Professional Modifier Low / Median / High Price $219.47 / $311.64 / $547.63	Professional		$219.47	$311.64	$547.63