Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $928.70 / $4,723.00 / $11,627.00	Facility		$928.70	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $928.70 / $928.70 / $1,853.28	Professional		$928.70	$928.70	$1,853.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,291.00 / $4,932.00 / $25,522.00	Facility		$2,291.00	$4,932.00	$25,522.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $737.17 / $1,033.88 / $1,743.12	Professional		$737.17	$1,033.88	$1,743.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $894.43 / $1,073.32 / $1,328.46	Facility		$894.43	$1,073.32	$1,328.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $924.39 / $983.87 / $983.87	Professional		$924.39	$983.87	$983.87
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 $821.19 / $1,252.20 / $1,914.08	Professional		$821.19	$1,252.20	$1,914.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $894.43 / $1,319.24 / $1,914.08	Professional		$894.43	$1,319.24	$1,914.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.32 / $787.52 / $1,280.42	Professional		$116.32	$787.52	$1,280.42
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 $808.45 / $1,187.65 / $2,069.39	Professional		$808.45	$1,187.65	$2,069.39