Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,559.61 / $5,135.00 / $11,627.00	Facility		$1,559.61	$5,135.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,559.61 / $1,588.92 / $3,041.24	Professional		$1,559.61	$1,588.92	$3,041.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,895.00 / $5,945.00 / $29,406.00	Facility		$1,895.00	$5,945.00	$29,406.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,107.83 / $1,550.77 / $2,600.79	Professional		$1,107.83	$1,550.77	$2,600.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,362.32 / $1,362.32 / $1,983.73	Facility		$1,362.32	$1,362.32	$1,983.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,432.40 / $1,469.17 / $1,469.17	Professional		$1,432.40	$1,469.17	$1,469.17
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 $1,246.00 / $1,869.86 / $2,832.85	Professional		$1,246.00	$1,869.86	$2,832.85
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,402.40 / $1,983.75 / $2,698.20	Professional		$1,402.40	$1,983.75	$2,698.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.99 / $1,213.53 / $1,867.35	Professional		$112.99	$1,213.53	$1,867.35
United Facility/Professional Facility Modifier Low / Median / High Price $1,480.00 / $3,086.00 / $6,792.00	Facility		$1,480.00	$3,086.00	$6,792.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,412.89 / $1,845.81 / $2,911.24	Professional		$1,412.89	$1,845.81	$2,911.24