Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $753.47 / $4,723.00 / $11,627.00	Facility		$753.47	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $652.49 / $763.56 / $1,371.82	Professional		$652.49	$763.56	$1,371.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,315.00 / $16,655.00 / $29,882.70	Facility		$3,315.00	$16,655.00	$29,882.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $613.02 / $829.15 / $1,363.76	Professional		$613.02	$829.15	$1,363.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $690.33 / $885.98 / $1,176.71	Facility		$690.33	$885.98	$1,176.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $812.15 / $1,033.65 / $127,498.73	Professional		$812.15	$1,033.65	$127,498.73
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 $775.24 / $1,033.65 / $1,438.71	Professional		$775.24	$1,033.65	$1,438.71
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $881.60 / $881.60 / $881.60	Facility		$881.60	$881.60	$881.60
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $775.24 / $1,050.52 / $1,473.33	Professional		$775.24	$1,050.52	$1,473.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $72.32 / $539.58 / $933.47	Professional		$72.32	$539.58	$933.47
United Facility/Professional Facility Modifier Low / Median / High Price $4,070.00 / $8,440.00 / $13,382.00	Facility		$4,070.00	$8,440.00	$13,382.00
United Facility/Professional Professional Modifier Low / Median / High Price $621.90 / $956.11 / $1,583.82	Professional		$621.90	$956.11	$1,583.82