Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.06 / $1,773.00 / $9,504.00	Facility		$28.06	$1,773.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.26 / $28.06 / $48.93	Professional		$21.26	$28.06	$48.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $2,059.00 / $2,412.00	Facility		$937.00	$2,059.00	$2,412.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.55 / $33.39 / $53.36	Professional		$21.55	$33.39	$53.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.95 / $34.88 / $34.88	Facility		$23.95	$34.88	$34.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.80 / $33.61 / $33.61	Professional		$23.80	$33.61	$33.61
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 $22.95 / $35.14 / $58.92	Professional		$22.95	$35.14	$58.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.51 / $36.67 / $57.77	Professional		$24.51	$36.67	$57.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.57 / $40.43 / $54.06	Professional		$27.57	$40.43	$54.06
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 $28.30 / $36.83 / $65.44	Professional		$28.30	$36.83	$65.44