Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,183.85 / $6,756.00 / $13,364.22	Facility		$1,183.85	$6,756.00	$13,364.22
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $135.49 / $149.04 / $524.00	Facility	53	$135.49	$149.04	$524.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $508.08 / $558.89 / $1,965.00	Facility	54	$508.08	$558.89	$1,965.00
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $101.62 / $111.78 / $393.00	Facility	55	$101.62	$111.78	$393.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $609.66 / $709.39 / $1,383.64	Professional		$609.66	$709.39	$1,383.64
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $91.45 / $101.62 / $139.24	Professional	55	$91.45	$101.62	$139.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $613.41 / $773.88 / $815.84	Professional		$613.41	$773.88	$815.84
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 $557.65 / $692.03 / $1,259.63	Professional		$557.65	$692.03	$1,259.63
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $709.15 / $709.15 / $709.15	Professional		$709.15	$709.15	$709.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $815.84 / $815.84 / $4,724.12	Facility		$815.84	$815.84	$4,724.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $690.33 / $722.30 / $815.84	Professional		$690.33	$722.30	$815.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $756.80 / $3,480.35 / $21,571.00	Facility		$756.80	$3,480.35	$21,571.00
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $151.22 / $151.22 / $151.22	Facility	53	$151.22	$151.22	$151.22
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $529.26 / $529.26 / $529.26	Facility	54	$529.26	$529.26	$529.26
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $113.41 / $113.41 / $113.41	Facility	55	$113.41	$113.41	$113.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $554.77 / $907.28 / $1,443.40	Professional		$554.77	$907.28	$1,443.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,931.87 / $3,480.35 / $3,881.00	Facility		$1,931.87	$3,480.35	$3,881.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $581.22 / $941.35 / $1,331.13	Professional		$581.22	$941.35	$1,331.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.93 / $459.40 / $802.41	Professional		$76.93	$459.40	$802.41
United Facility/Professional Facility Modifier Low / Median / High Price $2,912.00 / $6,557.00 / $10,989.00	Facility		$2,912.00	$6,557.00	$10,989.00
United Facility/Professional Professional Modifier Low / Median / High Price $614.41 / $798.67 / $1,491.35	Professional		$614.41	$798.67	$1,491.35