Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $248.58 / $2,820.50 / $9,504.00	Facility		$248.58	$2,820.50	$9,504.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,225.00 / $5,641.00 / $21,735.25	Facility	50	$3,225.00	$5,641.00	$21,735.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.10 / $861.83 / $1,645.27	Professional		$147.10	$861.83	$1,645.27
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,837.70 / $1,837.70 / $1,837.70	Professional	50	$1,837.70	$1,837.70	$1,837.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,786.00 / $8,800.00	Facility		$1,145.00	$2,786.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.13 / $700.00 / $1,448.68	Professional		$145.13	$700.00	$1,448.68
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $217.69 / $1,050.01 / $2,173.02	Professional	50	$217.69	$1,050.01	$2,173.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $140.72 / $168.88 / $263.87	Facility		$140.72	$168.88	$263.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $880.23 / $1,098.70 / $1,560.41	Professional		$880.23	$1,098.70	$1,560.41
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 $168.87 / $800.21 / $1,712.45	Professional		$168.87	$800.21	$1,712.45
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $172.83 / $808.21 / $1,755.19	Professional		$172.83	$808.21	$1,755.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $733.35 / $999.43 / $1,385.10	Professional		$733.35	$999.43	$1,385.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $2,665.00 / $5,268.00	Facility		$1,689.00	$2,665.00	$5,268.00
United Facility/Professional Professional Modifier Low / Median / High Price $901.53 / $1,234.51 / $2,000.49	Professional		$901.53	$1,234.51	$2,000.49