Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,375.57 / $5,135.00 / $11,627.00	Facility		$1,375.57	$5,135.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,375.57 / $1,376.99 / $2,682.36	Professional		$1,375.57	$1,376.99	$2,682.36
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 $1,104.46 / $1,513.52 / $2,420.11	Professional		$1,104.46	$1,513.52	$2,420.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,198.45 / $1,198.45 / $1,745.11	Facility		$1,198.45	$1,198.45	$1,745.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,292.45 / $1,292.45 / $1,360.25	Professional		$1,292.45	$1,292.45	$1,360.25
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 $1,103.26 / $1,649.07 / $2,603.04	Professional		$1,103.26	$1,649.07	$2,603.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,233.69 / $1,797.43 / $2,603.04	Professional		$1,233.69	$1,797.43	$2,603.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $106.74 / $1,156.06 / $1,678.11	Professional		$106.74	$1,156.06	$1,678.11
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 $1,240.08 / $1,634.56 / $2,633.54	Professional		$1,240.08	$1,634.56	$2,633.54