Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,450.00 / $6,637.00 / $16,921.00	Facility		$1,450.00	$6,637.00	$16,921.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $670.97 / $997.73 / $2,176.98	Facility	54	$670.97	$997.73	$2,176.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $782.64 / $933.82 / $1,777.41	Professional		$782.64	$933.82	$1,777.41
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $117.50 / $134.19 / $236.62	Professional	55	$117.50	$134.19	$236.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,152.00 / $3,175.00 / $8,800.00	Facility		$1,152.00	$3,175.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $683.57 / $924.84 / $1,646.31	Professional		$683.57	$924.84	$1,646.31
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $933.81 / $933.81 / $933.81	Professional		$933.81	$933.81	$933.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,074.29 / $1,317.05 / $1,611.44	Facility		$1,074.29	$1,317.05	$1,611.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $909.02 / $1,032.98 / $1,611.44	Professional		$909.02	$1,032.98	$1,611.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $999.42 / $1,124.08 / $21,571.00	Facility		$999.42	$1,124.08	$21,571.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $698.63 / $698.63 / $698.63	Facility	54	$698.63	$698.63	$698.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $746.66 / $1,156.93 / $1,786.32	Professional		$746.66	$1,156.93	$1,786.32
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,124.08 / $1,253.49 / $5,693.10	Facility		$1,124.08	$1,253.49	$5,693.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $755.35 / $1,113.33 / $1,681.51	Professional		$755.35	$1,113.33	$1,681.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.37 / $651.66 / $1,099.85	Professional		$76.37	$651.66	$1,099.85
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 $778.83 / $953.10 / $1,938.15	Professional		$778.83	$953.10	$1,938.15