Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,170.18 / $5,201.00 / $11,627.00	Facility		$1,170.18	$5,201.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,063.80 / $1,063.80 / $2,808.43	Professional		$1,063.80	$1,063.80	$2,808.43
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 $818.02 / $1,106.73 / $1,947.23	Professional		$818.02	$1,106.73	$1,947.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,006.65 / $1,207.98 / $1,887.47	Facility		$1,006.65	$1,207.98	$1,887.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,107.32 / $1,107.32 / $1,962.98	Professional		$1,107.32	$1,107.32	$1,962.98
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 $856.80 / $1,383.22 / $2,143.96	Professional		$856.80	$1,383.22	$2,143.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $884.92 / $1,409.30 / $2,108.81	Professional		$884.92	$1,409.30	$2,108.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.80 / $894.12 / $1,438.87	Professional		$115.80	$894.12	$1,438.87
United Facility/Professional Facility Modifier Low / Median / High Price $3,793.00 / $6,579.00 / $10,989.00	Facility		$3,793.00	$6,579.00	$10,989.00
United Facility/Professional Professional Modifier Low / Median / High Price $896.53 / $1,303.13 / $2,229.98	Professional		$896.53	$1,303.13	$2,229.98