Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,578.65 / $7,728.27 / $11,627.00	Facility		$2,578.65	$7,728.27	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,578.65 / $2,578.65 / $7,728.27	Professional		$2,578.65	$2,578.65	$7,728.27
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 $1,116.08 / $1,631.28 / $3,133.55	Professional		$1,116.08	$1,631.28	$3,133.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,250.73 / $2,250.73 / $3,277.39	Facility		$2,250.73	$2,250.73	$3,277.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,695.07 / $2,427.27 / $2,427.27	Professional		$1,695.07	$2,427.27	$2,427.27
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 $1,699.60 / $2,758.26 / $4,315.74	Professional		$1,699.60	$2,758.26	$4,315.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,903.42 / $2,958.64 / $4,246.71	Professional		$1,903.42	$2,958.64	$4,246.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $190.83 / $2,010.50 / $3,088.78	Professional		$190.83	$2,010.50	$3,088.78
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 $1,539.49 / $2,751.78 / $4,449.99	Professional		$1,539.49	$2,751.78	$4,449.99