Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $265.13 / $2,895.00 / $9,504.00	Facility		$265.13	$2,895.00	$9,504.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.70 / $1,407.78 / $2,670.55	Professional		$166.70	$1,407.78	$2,670.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,786.00 / $8,800.00	Facility		$1,145.00	$2,786.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.59 / $1,131.40 / $2,159.44	Professional		$147.59	$1,131.40	$2,159.44
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $221.39 / $1,697.10 / $3,239.16	Professional	50	$221.39	$1,697.10	$3,239.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $145.57 / $211.97 / $267.60	Facility		$145.57	$211.97	$267.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,256.50 / $1,775.79 / $2,227.42	Professional		$1,256.50	$1,775.79	$2,227.42
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 $164.21 / $404.66 / $2,336.98	Professional		$164.21	$404.66	$2,336.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $1,757.46 / $2,523.19 / $5,435.56	Facility		$1,757.46	$2,523.19	$5,435.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $171.27 / $404.66 / $2,336.98	Professional		$171.27	$404.66	$2,336.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,086.30 / $1,437.75 / $1,965.46	Professional		$1,086.30	$1,437.75	$1,965.46
United Facility/Professional Facility Modifier Low / Median / High Price $1,771.00 / $2,740.00 / $5,457.00	Facility		$1,771.00	$2,740.00	$5,457.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,526.78 / $2,070.35 / $3,148.33	Professional		$1,526.78	$2,070.35	$3,148.33