Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,198.87 / $6,666.46 / $11,627.00	Facility		$2,198.87	$6,666.46	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,198.87 / $2,260.62 / $5,761.04	Professional		$2,198.87	$2,260.62	$5,761.04
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 $1,593.16 / $2,249.16 / $3,740.16	Professional		$1,593.16	$2,249.16	$3,740.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,916.50 / $1,916.50 / $2,790.68	Facility		$1,916.50	$1,916.50	$2,790.68
CareSource Facility/Professional Professional Modifier Low / Median / High Price $2,066.81 / $2,066.81 / $2,529.64	Professional		$2,066.81	$2,066.81	$2,529.64
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 $1,749.86 / $2,875.16 / $4,171.33	Professional		$1,749.86	$2,875.16	$4,171.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,972.87 / $2,912.32 / $4,154.58	Professional		$1,972.87	$2,912.32	$4,154.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $184.79 / $1,898.19 / $2,696.73	Professional		$184.79	$1,898.19	$2,696.73
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 $2,023.75 / $2,636.73 / $3,789.99	Professional		$2,023.75	$2,636.73	$3,789.99