Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $175.91 / $2,039.00 / $8,553.00	Facility		$175.91	$2,039.00	$8,553.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.79 / $217.07 / $394.93	Professional		$85.79	$217.07	$394.93
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 $95.80 / $225.13 / $398.97	Professional		$95.80	$225.13	$398.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $92.89 / $111.47 / $174.17	Facility		$92.89	$111.47	$174.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $254.85 / $298.82 / $451.77	Professional		$254.85	$298.82	$451.77
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 $111.46 / $254.85 / $468.31	Professional		$111.46	$254.85	$468.31
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $862.21 / $902.54 / $1,135.22	Facility		$862.21	$902.54	$1,135.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $115.18 / $259.50 / $468.31	Professional		$115.18	$259.50	$468.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.91 / $269.27 / $366.93	Professional		$199.91	$269.27	$366.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $2,048.00 / $4,132.00	Facility		$1,106.00	$2,048.00	$4,132.00
United Facility/Professional Professional Modifier Low / Median / High Price $228.50 / $338.23 / $546.54	Professional		$228.50	$338.23	$546.54