Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $176.87 / $4,723.00 / $11,627.00	Facility		$176.87	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.87 / $176.87 / $357.80	Professional		$176.87	$176.87	$357.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $2,059.00 / $2,412.00	Facility		$937.00	$2,059.00	$2,412.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.07 / $192.21 / $316.89	Professional		$146.07	$192.21	$316.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.38 / $154.38 / $224.80	Facility		$154.38	$154.38	$224.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $166.49 / $166.49 / $185.11	Professional		$166.49	$166.49	$185.11
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 $152.28 / $226.97 / $344.26	Professional		$152.28	$226.97	$344.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $161.86 / $232.32 / $336.28	Professional		$161.86	$232.32	$336.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $149.52 / $196.18 / $258.95	Professional		$149.52	$196.18	$258.95
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $979.00 / $3,218.00	Facility		$444.00	$979.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $164.46 / $216.68 / $342.11	Professional		$164.46	$216.68	$342.11