Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,701.58 / $5,230.26 / $11,627.00	Facility		$1,701.58	$5,230.26	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,701.58 / $1,731.31 / $3,318.08	Professional		$1,701.58	$1,731.31	$3,318.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,638.88 / $7,944.89 / $15,216.00	Facility		$3,638.88	$7,944.89	$15,216.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,296.26 / $1,825.42 / $3,043.15	Professional		$1,296.26	$1,825.42	$3,043.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,484.51 / $2,161.65 / $2,728.88	Facility		$1,484.51	$2,161.65	$2,728.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,600.94 / $1,743.27 / $2,838.03	Professional		$1,600.94	$1,743.27	$2,838.03
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 $1,367.74 / $2,064.62 / $3,101.28	Professional		$1,367.74	$2,064.62	$3,101.28
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,528.66 / $2,214.09 / $3,055.04	Professional		$1,528.66	$2,214.09	$3,055.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.32 / $1,321.34 / $2,071.95	Professional		$116.32	$1,321.34	$2,071.95
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 $1,547.28 / $2,035.90 / $3,264.88	Professional		$1,547.28	$2,035.90	$3,264.88