Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,221.34 / $5,135.00 / $11,581.00	Facility		$1,221.34	$5,135.00	$11,581.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $616.01 / $916.01 / $1,830.83	Facility	54	$616.01	$916.01	$1,830.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.25 / $821.35 / $1,573.21	Professional		$656.25	$821.35	$1,573.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $977.44 / $977.44 / $977.44	Professional		$977.44	$977.44	$977.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,152.00 / $3,025.00 / $8,800.00	Facility		$1,152.00	$3,025.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $553.30 / $755.11 / $1,332.58	Professional		$553.30	$755.11	$1,332.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $977.44 / $1,198.31 / $1,525.80	Facility		$977.44	$1,198.31	$1,525.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $623.35 / $939.85 / $1,466.16	Professional		$623.35	$939.85	$1,466.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $925.34 / $1,124.08 / $21,571.00	Facility		$925.34	$1,124.08	$21,571.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $647.74 / $647.74 / $647.74	Facility	54	$647.74	$647.74	$647.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $686.83 / $984.76 / $1,621.54	Professional		$686.83	$984.76	$1,621.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,124.08 / $1,124.08 / $1,253.49	Facility		$1,124.08	$1,124.08	$1,253.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $657.39 / $1,020.77 / $1,445.03	Professional		$657.39	$1,020.77	$1,445.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.18 / $565.61 / $1,004.18	Professional		$76.18	$565.61	$1,004.18
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 $649.33 / $829.17 / $1,689.88	Professional		$649.33	$829.17	$1,689.88