Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $188.94 / $1,967.00 / $9,516.00	Facility		$188.94	$1,967.00	$9,516.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.49 / $195.09 / $339.63	Professional		$128.49	$195.09	$339.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,051.00 / $1,981.00 / $3,943.00	Facility		$1,051.00	$1,981.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.60 / $178.69 / $317.13	Professional		$109.60	$178.69	$317.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $143.05 / $208.31 / $208.31	Facility		$143.05	$208.31	$208.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $167.52 / $231.10 / $231.10	Professional		$167.52	$231.10	$231.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,571.00 / $21,571.00 / $21,571.00	Facility		$21,571.00	$21,571.00	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $219.70 / $379.74	Professional		$131.83	$219.70	$379.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $147.26 / $231.09 / $367.65	Professional		$147.26	$231.09	$367.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $175.55 / $235.19 / $342.00	Professional		$175.55	$235.19	$342.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,930.00 / $4,067.00	Facility		$1,020.00	$1,930.00	$4,067.00
United Facility/Professional Professional Modifier Low / Median / High Price $175.31 / $236.39 / $391.88	Professional		$175.31	$236.39	$391.88