Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $393.58 / $4,044.00 / $9,863.00	Facility		$393.58	$4,044.00	$9,863.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.25 / $746.59 / $3,914.75	Professional		$239.25	$746.59	$3,914.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.40 / $246.82 / $318.82	Professional		$223.40	$246.82	$318.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,009.00 / $3,974.00 / $19,117.00	Facility		$2,009.00	$3,974.00	$19,117.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.14 / $1,555.99 / $3,678.85	Professional		$222.14	$1,555.99	$3,678.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $209.81 / $209.81 / $305.51	Facility		$209.81	$209.81	$305.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,748.74 / $1,864.48 / $1,864.48	Professional		$1,748.74	$1,864.48	$1,864.48
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 $226.26 / $499.35 / $3,635.55	Professional		$226.26	$499.35	$3,635.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $246.82 / $540.10 / $3,611.52	Professional		$246.82	$540.10	$3,611.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,584.93 / $2,097.70 / $2,887.14	Professional		$1,584.93	$2,097.70	$2,887.14
United Facility/Professional Facility Modifier Low / Median / High Price $4,070.00 / $8,448.00 / $13,382.00	Facility		$4,070.00	$8,448.00	$13,382.00
United Facility/Professional Professional Modifier Low / Median / High Price $2,306.96 / $3,118.99 / $4,569.16	Professional		$2,306.96	$3,118.99	$4,569.16