Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $951.70 / $7,391.05 / $11,561.00	Facility		$951.70	$7,391.05	$11,561.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $463.13 / $688.68 / $2,271.02	Facility	54	$463.13	$688.68	$2,271.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $617.51 / $875.54 / $1,651.46	Professional		$617.51	$875.54	$1,651.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $696.20 / $696.20 / $706.24	Professional		$696.20	$696.20	$706.24
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 $763.89 / $1,057.29 / $1,949.74	Professional		$763.89	$1,057.29	$1,949.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $741.82 / $909.44 / $2,631.55	Facility		$741.82	$909.44	$2,631.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $627.69 / $713.29 / $1,112.73	Professional		$627.69	$713.29	$1,112.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $692.33 / $1,938.72 / $21,571.00	Facility		$692.33	$1,938.72	$21,571.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $484.63 / $484.63 / $484.63	Facility	54	$484.63	$484.63	$484.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $574.02 / $965.13 / $1,990.31	Professional		$574.02	$965.13	$1,990.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,938.72 / $1,938.72 / $2,161.90	Facility		$1,938.72	$1,938.72	$2,161.90
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $485.04 / $1,020.15 / $1,894.76	Professional		$485.04	$1,020.15	$1,894.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.18 / $417.14 / $742.18	Professional		$76.18	$417.14	$742.18
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $6,231.00 / $10,075.00	Facility		$2,912.00	$6,231.00	$10,075.00
United Facility/Professional Professional Modifier Low / Median / High Price $801.88 / $1,109.33 / $1,779.00	Professional		$801.88	$1,109.33	$1,779.00