Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $176.54 / $2,113.00 / $10,268.00	Facility		$176.54	$2,113.00	$10,268.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.95 / $177.86 / $318.36	Professional		$107.95	$177.86	$318.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $260.91 / $260.91 / $260.91	Professional	50	$260.91	$260.91	$260.91
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 $62.22 / $103.56 / $192.17	Professional		$62.22	$103.56	$192.17
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $93.33 / $154.27 / $288.25	Professional	50	$93.33	$154.27	$288.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.10 / $123.72 / $164.31	Facility		$103.10	$123.72	$164.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $184.39 / $184.39 / $326.88	Professional		$184.39	$184.39	$326.88
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 $110.91 / $194.85 / $327.81	Professional		$110.91	$194.85	$327.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $121.37 / $204.51 / $332.07	Professional		$121.37	$204.51	$332.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $123.24 / $171.39 / $246.02	Professional		$123.24	$171.39	$246.02
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $979.00 / $3,218.00	Facility		$444.00	$979.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $150.34 / $217.83 / $375.24	Professional		$150.34	$217.83	$375.24