Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.29 / $2,113.00 / $10,268.00	Facility		$208.29	$2,113.00	$10,268.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.41 / $208.29 / $357.21	Professional		$147.41	$208.29	$357.21
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 $147.16 / $207.11 / $356.40	Professional		$147.16	$207.11	$356.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $163.51 / $238.09 / $238.09	Facility		$163.51	$238.09	$238.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $216.71 / $247.01 / $247.01	Professional		$216.71	$247.01	$247.01
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 $157.11 / $251.13 / $408.39	Professional		$157.11	$251.13	$408.39
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $168.33 / $258.24 / $403.16	Professional		$168.33	$258.24	$403.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $156.38 / $220.47 / $317.56	Professional		$156.38	$220.47	$317.56
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 $190.34 / $250.46 / $416.35	Professional		$190.34	$250.46	$416.35