Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,608.71 / $5,135.00 / $11,627.00	Facility		$1,608.71	$5,135.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,608.71 / $1,608.71 / $3,276.53	Professional		$1,608.71	$1,608.71	$3,276.53
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 $977.46 / $1,482.75 / $2,403.48	Professional		$977.46	$1,482.75	$2,403.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,400.38 / $2,039.14 / $2,574.23	Facility		$1,400.38	$2,039.14	$2,574.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,508.62 / $1,510.21 / $2,677.20	Professional		$1,508.62	$1,510.21	$2,677.20
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 $1,236.09 / $1,922.09 / $2,993.42	Professional		$1,236.09	$1,922.09	$2,993.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,441.57 / $1,997.87 / $2,993.42	Professional		$1,441.57	$1,997.87	$2,993.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $117.78 / $1,231.72 / $1,901.46	Professional		$117.78	$1,231.72	$1,901.46
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 $1,478.85 / $1,936.65 / $3,026.98	Professional		$1,478.85	$1,936.65	$3,026.98