Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.73 / $2,849.00 / $10,268.00	Facility		$174.73	$2,849.00	$10,268.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.87 / $174.73 / $308.14	Professional		$116.87	$174.73	$308.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $772.00 / $2,141.00 / $3,111.00	Facility		$772.00	$2,141.00	$3,111.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $200.21 / $338.21	Professional		$136.22	$200.21	$338.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $129.01 / $187.85 / $187.85	Facility		$129.01	$187.85	$187.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $195.35 / $206.55 / $206.55	Professional		$195.35	$206.55	$206.55
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 $123.95 / $201.18 / $341.61	Professional		$123.95	$201.18	$341.61
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $132.80 / $214.23 / $322.79	Professional		$132.80	$214.23	$322.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $163.59 / $220.27 / $311.05	Professional		$163.59	$220.27	$311.05
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 $163.34 / $227.86 / $417.33	Professional		$163.34	$227.86	$417.33