Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,355.75 / $5,135.00 / $11,627.00	Facility		$1,355.75	$5,135.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,355.75 / $1,355.75 / $2,643.71	Professional		$1,355.75	$1,355.75	$2,643.71
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 $1,079.54 / $1,427.77 / $2,432.92	Professional		$1,079.54	$1,427.77	$2,432.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,180.52 / $1,719.01 / $2,170.10	Facility		$1,180.52	$1,719.01	$2,170.10
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,273.11 / $1,343.66 / $2,256.89	Professional		$1,273.11	$1,343.66	$2,256.89
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 $1,089.90 / $1,625.46 / $2,544.30	Professional		$1,089.90	$1,625.46	$2,544.30
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,217.84 / $1,770.44 / $2,544.30	Professional		$1,217.84	$1,770.44	$2,544.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $106.74 / $1,124.16 / $1,634.36	Professional		$106.74	$1,124.16	$1,634.36
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 $1,223.98 / $1,605.49 / $2,601.08	Professional		$1,223.98	$1,605.49	$2,601.08