Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $321.76 / $4,947.00 / $11,581.00	Facility		$321.76	$4,947.00	$11,581.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $98.48 / $309.18 / $948.52	Facility	52	$98.48	$309.18	$948.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.95 / $557.45 / $1,060.48	Professional		$196.95	$557.45	$1,060.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $98.48 / $304.08 / $479.45	Professional	52	$98.48	$304.08	$479.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $3,528.00 / $14,996.00	Facility		$1,760.00	$3,528.00	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.22 / $500.65 / $1,069.30	Professional		$174.22	$500.65	$1,069.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $172.14 / $200.40 / $250.65	Facility		$172.14	$200.40	$250.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $450.81 / $565.21 / $565.21	Professional		$450.81	$565.21	$565.21
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 $194.07 / $387.57 / $1,031.63	Professional		$194.07	$387.57	$1,031.63
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $202.51 / $513.03 / $1,031.63	Professional		$202.51	$513.03	$1,031.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $479.15 / $631.61 / $865.68	Professional		$479.15	$631.61	$865.68
United Facility/Professional Facility Modifier Low / Median / High Price $2,840.00 / $5,920.00 / $7,847.00	Facility		$2,840.00	$5,920.00	$7,847.00
United Facility/Professional Professional Modifier Low / Median / High Price $583.70 / $788.26 / $1,224.64	Professional		$583.70	$788.26	$1,224.64