Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $900.00 / $4,085.00 / $11,581.00	Facility		$900.00	$4,085.00	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $705.36 / $950.64 / $1,616.81	Professional		$705.36	$950.64	$1,616.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $422.10 / $422.10 / $1,073.93	Professional		$422.10	$422.10	$1,073.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,792.00 / $8,800.00	Facility		$1,145.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $732.86 / $1,028.35 / $1,779.92	Professional		$732.86	$1,028.35	$1,779.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $782.44 / $1,139.33 / $1,139.33	Facility		$782.44	$1,139.33	$1,139.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $909.75 / $1,020.46 / $1,020.46	Professional		$909.75	$1,020.46	$1,020.46
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 $717.23 / $1,078.19 / $1,809.62	Professional		$717.23	$1,078.19	$1,809.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $779.92 / $1,152.08 / $1,706.37	Professional		$779.92	$1,152.08	$1,706.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $111.35 / $705.98 / $1,199.47	Professional		$111.35	$705.98	$1,199.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $2,551.00 / $5,235.00	Facility		$1,689.00	$2,551.00	$5,235.00
United Facility/Professional Professional Modifier Low / Median / High Price $795.63 / $1,109.58 / $1,787.63	Professional		$795.63	$1,109.58	$1,787.63