Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,838.07 / $6,582.00 / $11,627.00	Facility		$1,838.07	$6,582.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,615.01 / $1,858.38 / $4,815.74	Professional		$1,615.01	$1,858.38	$4,815.74
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 $1,398.88 / $2,139.46 / $3,639.13	Professional		$1,398.88	$2,139.46	$3,639.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,602.20 / $1,602.20 / $2,333.03	Facility		$1,602.20	$1,602.20	$2,333.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,727.87 / $1,727.87 / $2,122.25	Professional		$1,727.87	$1,727.87	$2,122.25
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 $1,518.09 / $2,412.12 / $3,481.73	Professional		$1,518.09	$2,412.12	$3,481.73
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,646.38 / $2,434.73 / $3,581.64	Professional		$1,646.38	$2,434.73	$3,581.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $148.90 / $1,435.57 / $2,196.88	Professional		$148.90	$1,435.57	$2,196.88
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 $1,688.38 / $2,175.75 / $3,700.32	Professional		$1,688.38	$2,175.75	$3,700.32