Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,363.35 / $7,135.86 / $11,627.00	Facility		$2,363.35	$7,135.86	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,363.35 / $2,418.54 / $6,191.98	Professional		$2,363.35	$2,418.54	$6,191.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,097.00 / $8,010.00 / $36,529.00	Facility		$2,097.00	$8,010.00	$36,529.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,574.40 / $2,282.87 / $3,696.12	Professional		$1,574.40	$2,282.87	$3,696.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,058.48 / $2,058.48 / $2,997.43	Facility		$2,058.48	$2,058.48	$2,997.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,219.92 / $2,219.92 / $2,504.98	Professional		$2,219.92	$2,219.92	$2,504.98
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 $1,886.56 / $2,985.56 / $4,486.42	Professional		$1,886.56	$2,985.56	$4,486.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,108.51 / $3,089.45 / $4,273.46	Professional		$2,108.51	$3,089.45	$4,273.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $183.77 / $1,835.92 / $2,815.76	Professional		$183.77	$1,835.92	$2,815.76
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 $2,108.52 / $2,724.46 / $4,407.91	Professional		$2,108.52	$2,724.46	$4,407.91