Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $787.64 / $4,723.00 / $11,627.00	Facility		$787.64	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $787.64 / $787.64 / $1,616.95	Professional		$787.64	$787.64	$1,616.95
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 $694.16 / $983.56 / $1,652.36	Professional		$694.16	$983.56	$1,652.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $752.83 / $903.40 / $1,118.15	Facility		$752.83	$903.40	$1,118.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $828.11 / $828.11 / $893.31	Professional		$828.11	$828.11	$893.31
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 $754.43 / $1,158.90 / $1,611.42	Professional		$754.43	$1,158.90	$1,611.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $783.45 / $1,158.90 / $1,687.73	Professional		$783.45	$1,158.90	$1,687.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.89 / $783.16 / $1,106.17	Professional		$75.89	$783.16	$1,106.17
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 $709.53 / $1,014.98 / $1,748.06	Professional		$709.53	$1,014.98	$1,748.06