Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,742.71 / $5,568.23 / $11,627.00	Facility		$1,742.71	$5,568.23	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,742.71 / $1,742.71 / $3,451.14	Professional		$1,742.71	$1,742.71	$3,451.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,084.00 / $4,426.00 / $19,117.00	Facility		$2,084.00	$4,426.00	$19,117.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,430.13 / $1,934.88 / $3,102.71	Professional		$1,430.13	$1,934.88	$3,102.71
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,518.48 / $2,211.11 / $2,791.32	Facility		$1,518.48	$2,211.11	$2,791.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,637.57 / $1,715.56 / $2,902.97	Professional		$1,637.57	$1,715.56	$2,902.97
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 $1,402.82 / $2,090.38 / $3,370.57	Professional		$1,402.82	$2,090.38	$3,370.57
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,567.86 / $2,276.62 / $3,302.11	Professional		$1,567.86	$2,276.62	$3,302.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $117.78 / $1,351.22 / $2,078.16	Professional		$117.78	$1,351.22	$2,078.16
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 $1,608.22 / $2,155.35 / $3,348.62	Professional		$1,608.22	$2,155.35	$3,348.62