Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,375.00 / $6,251.00 / $11,581.00	Facility		$1,375.00	$6,251.00	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $978.41 / $978.41 / $2,579.00	Professional		$978.41	$978.41	$2,579.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,084.00 / $4,437.00 / $19,117.00	Facility		$2,084.00	$4,437.00	$19,117.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $760.91 / $1,095.93 / $1,811.24	Professional		$760.91	$1,095.93	$1,811.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $925.04 / $1,110.05 / $1,373.93	Facility		$925.04	$1,110.05	$1,373.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $870.19 / $1,017.54 / $1,017.54	Professional		$870.19	$1,017.54	$1,017.54
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 $788.62 / $1,280.70 / $1,975.01	Professional		$788.62	$1,280.70	$1,975.01
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $863.50 / $1,295.05 / $1,941.12	Professional		$863.50	$1,295.05	$1,941.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.96 / $797.34 / $1,314.38	Professional		$112.96	$797.34	$1,314.38
United Facility/Professional Facility Modifier Low / Median / High Price $3,206.00 / $6,578.00 / $10,075.00	Facility		$3,206.00	$6,578.00	$10,075.00
United Facility/Professional Professional Modifier Low / Median / High Price $823.70 / $1,147.67 / $2,072.59	Professional		$823.70	$1,147.67	$2,072.59