Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,893.81 / $5,807.26 / $11,627.00	Facility		$1,893.81	$5,807.26	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,893.81 / $1,968.48 / $3,542.61	Professional		$1,893.81	$1,968.48	$3,542.61
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 $1,272.89 / $1,814.54 / $3,003.85	Professional		$1,272.89	$1,814.54	$3,003.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,652.12 / $2,405.71 / $3,036.99	Facility		$1,652.12	$2,405.71	$3,036.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,517.29 / $1,781.70 / $3,158.48	Professional		$1,517.29	$1,781.70	$3,158.48
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 $1,518.13 / $2,267.63 / $3,475.20	Professional		$1,518.13	$2,267.63	$3,475.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,619.73 / $2,273.19 / $3,475.20	Professional		$1,619.73	$2,273.19	$3,475.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $149.16 / $1,479.38 / $2,270.27	Professional		$149.16	$1,479.38	$2,270.27
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 $1,719.40 / $2,242.67 / $3,549.32	Professional		$1,719.40	$2,242.67	$3,549.32