Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $300.33 / $3,862.00 / $9,863.00	Facility		$300.33	$3,862.00	$9,863.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,003.80 / $3,277.00 / $3,277.00	Facility	50	$1,003.80	$3,277.00	$3,277.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.67 / $1,559.00 / $3,831.30	Professional		$176.67	$1,559.00	$3,831.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,895.00 / $5,563.00 / $29,406.00	Facility		$1,895.00	$5,563.00	$29,406.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.57 / $1,304.02 / $5,604.11	Professional		$194.57	$1,304.02	$5,604.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $291.86 / $1,956.04 / $8,406.16	Professional	50	$291.86	$1,956.04	$8,406.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $170.20 / $204.24 / $319.13	Facility		$170.20	$204.24	$319.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,562.56 / $2,579.27 / $2,769.99	Professional		$1,562.56	$2,579.27	$2,769.99
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 $200.00 / $503.95 / $3,672.11	Professional		$200.00	$503.95	$3,672.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $211.05 / $583.96 / $3,784.73	Professional		$211.05	$583.96	$3,784.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,323.87 / $1,809.62 / $2,503.77	Professional		$1,323.87	$1,809.62	$2,503.77
United Facility/Professional Facility Modifier Low / Median / High Price $2,840.00 / $5,998.00 / $7,847.00	Facility		$2,840.00	$5,998.00	$7,847.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,790.91 / $2,743.41 / $5,094.67	Professional		$1,790.91	$2,743.41	$5,094.67