Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $308.22 / $1,967.00 / $9,516.00	Facility		$308.22	$1,967.00	$9,516.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $185.68 / $314.99 / $540.65	Professional		$185.68	$314.99	$540.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.18 / $258.70 / $471.52	Professional		$170.18	$258.70	$471.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $205.94 / $299.88 / $299.88	Facility		$205.94	$299.88	$299.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $267.35 / $362.78 / $362.78	Professional		$267.35	$362.78	$362.78
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 $212.01 / $327.35 / $577.15	Professional		$212.01	$327.35	$577.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $214.28 / $329.80 / $553.91	Professional		$214.28	$329.80	$553.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.85 / $295.30 / $466.57	Professional		$31.85	$295.30	$466.57
United Facility/Professional Facility Modifier Low / Median / High Price $296.06 / $738.00 / $2,816.00	Facility		$296.06	$738.00	$2,816.00
United Facility/Professional Professional Modifier Low / Median / High Price $256.67 / $366.67 / $605.53	Professional		$256.67	$366.67	$605.53