Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,733.70 / $5,234.87 / $11,627.00	Facility		$1,733.70	$5,234.87	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,515.68 / $1,754.67 / $4,542.29	Professional		$1,515.68	$1,754.67	$4,542.29
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 $1,317.79 / $1,977.14 / $3,274.91	Professional		$1,317.79	$1,977.14	$3,274.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,512.86 / $1,512.86 / $2,202.92	Facility		$1,512.86	$1,512.86	$2,202.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,631.52 / $1,631.52 / $1,988.74	Professional		$1,631.52	$1,631.52	$1,988.74
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 $1,394.21 / $2,262.56 / $3,285.49	Professional		$1,394.21	$2,262.56	$3,285.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,552.29 / $2,298.96 / $3,332.05	Professional		$1,552.29	$2,298.96	$3,332.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $112.99 / $1,358.61 / $2,088.87	Professional		$112.99	$1,358.61	$2,088.87
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 $1,592.47 / $2,053.07 / $3,211.30	Professional		$1,592.47	$2,053.07	$3,211.30