Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,422.61 / $6,075.00 / $11,627.00	Facility		$1,422.61	$6,075.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,422.61 / $1,422.61 / $2,771.76	Professional		$1,422.61	$1,422.61	$2,771.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,142.00 / $14,489.11 / $24,772.14	Facility		$4,142.00	$14,489.11	$24,772.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,194.06 / $1,694.12 / $2,802.27	Professional		$1,194.06	$1,694.12	$2,802.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,358.71 / $1,630.45 / $2,018.04	Facility		$1,358.71	$1,630.45	$2,018.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,494.58 / $1,494.58 / $1,598.54	Professional		$1,494.58	$1,494.58	$1,598.54
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 $1,278.00 / $1,967.83 / $2,860.18	Professional		$1,278.00	$1,967.83	$2,860.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,372.30 / $2,050.23 / $2,839.47	Professional		$1,372.30	$2,050.23	$2,839.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $119.23 / $1,176.59 / $1,918.28	Professional		$119.23	$1,176.59	$1,918.28
United Facility/Professional Facility Modifier Low / Median / High Price $1,480.00 / $3,086.00 / $6,111.00	Facility		$1,480.00	$3,086.00	$6,111.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,255.25 / $1,806.74 / $3,054.66	Professional		$1,255.25	$1,806.74	$3,054.66