Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $935.34 / $8,956.00 / $11,627.00	Facility		$935.34	$8,956.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $603.95 / $935.34 / $956.38	Professional		$603.95	$935.34	$956.38
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 $844.84 / $1,143.03 / $2,058.25	Professional		$844.84	$1,143.03	$2,058.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,062.47 / $15,185.52 / $30,479.55	Facility		$1,062.47	$15,185.52	$30,479.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,108.34 / $16,625.21 / $29,338.61	Professional		$1,108.34	$16,625.21	$29,338.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,152.40 / $2,732.59 / $21,571.00	Facility		$1,152.40	$2,732.59	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,543.24 / $4,543.24 / $4,543.24	Professional		$4,543.24	$4,543.24	$4,543.24
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,732.59 / $2,732.59 / $3,047.16	Facility		$2,732.59	$2,732.59	$3,047.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $60.00	Professional		$40.00	$50.00	$60.00
United Facility/Professional Facility Modifier Low / Median / High Price $3,206.00 / $6,579.00 / $10,989.00	Facility		$3,206.00	$6,579.00	$10,989.00
United Facility/Professional Professional Modifier Low / Median / High Price $867.68 / $1,175.25 / $2,391.57	Professional		$867.68	$1,175.25	$2,391.57