Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,758.29 / $5,330.32 / $11,627.00	Facility		$1,758.29	$5,330.32	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,758.29 / $1,758.29 / $3,464.90	Professional		$1,758.29	$1,758.29	$3,464.90
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 $1,390.46 / $1,838.85 / $2,940.32	Professional		$1,390.46	$1,838.85	$2,940.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,531.67 / $2,230.33 / $2,815.58	Facility		$1,531.67	$2,230.33	$2,815.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,395.46 / $1,651.80 / $2,928.20	Professional		$1,395.46	$1,651.80	$2,928.20
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 $1,411.55 / $2,102.30 / $3,355.96	Professional		$1,411.55	$2,102.30	$3,355.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,580.99 / $2,297.58 / $3,330.39	Professional		$1,580.99	$2,297.58	$3,330.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $149.16 / $1,381.56 / $2,112.14	Professional		$149.16	$1,381.56	$2,112.14
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 $1,621.18 / $2,108.12 / $3,376.66	Professional		$1,621.18	$2,108.12	$3,376.66