Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,263.33 / $7,465.00 / $14,579.00	Facility		$1,263.33	$7,465.00	$14,579.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $637.19 / $700.91 / $2,627.25	Facility	54	$637.19	$700.91	$2,627.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $761.10 / $853.76 / $1,553.00	Professional		$761.10	$853.76	$1,553.00
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $114.17 / $127.44 / $174.47	Professional	55	$114.17	$127.44	$174.47
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 $700.68 / $866.70 / $1,582.71	Professional		$700.68	$866.70	$1,582.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,021.23 / $1,021.23 / $4,728.10	Facility		$1,021.23	$1,021.23	$4,728.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $864.12 / $907.57 / $1,021.23	Professional		$864.12	$907.57	$1,021.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $949.72 / $3,483.30 / $21,571.00	Facility		$949.72	$3,483.30	$21,571.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $662.09 / $662.09 / $662.09	Facility	54	$662.09	$662.09	$662.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $696.85 / $1,139.06 / $1,806.78	Professional		$696.85	$1,139.06	$1,806.78
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $3,483.30 / $3,483.30 / $3,884.29	Facility		$3,483.30	$3,483.30	$3,884.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $696.85 / $1,140.69 / $1,671.05	Professional		$696.85	$1,140.69	$1,671.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.09 / $610.77 / $1,031.54	Professional		$77.09	$610.77	$1,031.54
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 $777.10 / $1,013.62 / $2,005.85	Professional		$777.10	$1,013.62	$2,005.85