Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $493.15 / $2,849.00 / $10,268.00	Facility		$493.15	$2,849.00	$10,268.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.20 / $450.47 / $709.82	Professional		$313.20	$450.47	$709.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $2,012.00 / $3,943.00	Facility		$937.00	$2,012.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.75 / $475.90 / $808.58	Professional		$309.75	$475.90	$808.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $369.37 / $537.86 / $537.86	Facility		$369.37	$537.86	$537.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $426.04 / $584.40 / $584.40	Professional		$426.04	$584.40	$584.40
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 $380.24 / $554.67 / $929.73	Professional		$380.24	$554.67	$929.73
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $383.38 / $562.76 / $890.42	Professional		$383.38	$562.76	$890.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.26 / $519.29 / $789.50	Professional		$69.26	$519.29	$789.50
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $975.00 / $2,914.00	Facility		$444.00	$975.00	$2,914.00
United Facility/Professional Professional Modifier Low / Median / High Price $448.23 / $589.70 / $1,024.27	Professional		$448.23	$589.70	$1,024.27