Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,257.58 / $6,873.91 / $11,627.00	Facility		$2,257.58	$6,873.91	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,257.58 / $2,258.37 / $6,873.91	Professional		$2,257.58	$2,258.37	$6,873.91
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 $1,720.31 / $2,248.90 / $3,732.27	Professional		$1,720.31	$2,248.90	$3,732.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,966.26 / $1,966.26 / $2,863.14	Facility		$1,966.26	$1,966.26	$2,863.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,120.48 / $2,120.48 / $2,218.87	Professional		$2,120.48	$2,120.48	$2,218.87
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 $1,812.05 / $2,698.79 / $4,287.77	Professional		$1,812.05	$2,698.79	$4,287.77
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,024.10 / $2,949.97 / $4,084.69	Professional		$2,024.10	$2,949.97	$4,084.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $184.79 / $1,970.70 / $2,776.53	Professional		$184.79	$1,970.70	$2,776.53
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 $2,052.42 / $2,673.46 / $4,388.41	Professional		$2,052.42	$2,673.46	$4,388.41