Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $723.65 / $4,723.00 / $11,627.00	Facility		$723.65	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $723.65 / $723.65 / $1,429.09	Professional		$723.65	$723.65	$1,429.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,408.00 / $14,299.15 / $25,723.30	Facility		$4,408.00	$14,299.15	$25,723.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $506.66 / $744.28 / $1,243.33	Professional		$506.66	$744.28	$1,243.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $692.31 / $830.77 / $1,103.36	Facility		$692.31	$830.77	$1,103.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $761.54 / $761.54 / $1,350.00	Professional		$761.54	$761.54	$1,350.00
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 $672.80 / $969.24 / $1,480.67	Professional		$672.80	$969.24	$1,480.67
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $703.54 / $1,011.96 / $1,480.67	Professional		$703.54	$1,011.96	$1,480.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.29 / $599.76 / $972.45	Professional		$78.29	$599.76	$972.45
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 $644.20 / $880.68 / $1,586.30	Professional		$644.20	$880.68	$1,586.30