Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,073.21 / $6,064.00 / $10,270.00	Facility		$1,073.21	$6,064.00	$10,270.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $554.45 / $824.46 / $1,904.20	Facility	54	$554.45	$824.46	$1,904.20
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $110.89 / $164.89 / $380.84	Facility	55	$110.89	$164.89	$380.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $739.26 / $995.39 / $2,538.92	Professional		$739.26	$995.39	$2,538.92
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $535.25 / $579.04 / $1,072.58	Professional	54	$535.25	$579.04	$1,072.58
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $107.05 / $111.24 / $195.25	Professional	55	$107.05	$111.24	$195.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $631.67 / $683.57 / $888.64	Professional		$631.67	$683.57	$888.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,191.00 / $3,232.00 / $8,800.00	Facility		$1,191.00	$3,232.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $787.44 / $952.81 / $1,848.65	Professional		$787.44	$952.81	$1,848.65
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $772.43 / $772.43 / $888.64	Professional		$772.43	$772.43	$888.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $683.57 / $854.46 / $1,025.35	Facility		$683.57	$854.46	$1,025.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $683.57 / $854.46 / $1,125.79	Professional		$683.57	$854.46	$1,125.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $826.04 / $1,124.08 / $21,571.00	Facility		$826.04	$1,124.08	$21,571.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $577.02 / $577.02 / $577.02	Facility	54	$577.02	$577.02	$577.02
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $123.65 / $123.65 / $123.65	Facility	55	$123.65	$123.65	$123.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $617.10 / $991.17 / $1,937.03	Professional		$617.10	$991.17	$1,937.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,124.08 / $2,443.56 / $5,371.16	Facility		$1,124.08	$2,443.56	$5,371.16
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $624.91 / $991.17 / $1,643.87	Professional		$624.91	$991.17	$1,643.87
Medical Mutual of Ohio Facility/Professional Professional Modifier 54 Low / Median / High Price $1,801.01 / $1,801.01 / $1,801.01	Professional	54	$1,801.01	$1,801.01	$1,801.01
Medical Mutual of Ohio Facility/Professional Professional Modifier 55 Low / Median / High Price $192.97 / $192.97 / $192.97	Professional	55	$192.97	$192.97	$192.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.37 / $545.13 / $906.73	Professional		$76.37	$545.13	$906.73
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 $685.64 / $932.02 / $1,669.59	Professional		$685.64	$932.02	$1,669.59