Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $533.33 / $4,085.00 / $10,268.00	Facility		$533.33	$4,085.00	$10,268.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $327.91 / $1,613.24 / $2,801.07	Professional		$327.91	$1,613.24	$2,801.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $336.73 / $336.73 / $336.73	Professional		$336.73	$336.73	$336.73
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 $292.60 / $1,194.55 / $2,356.61	Professional		$292.60	$1,194.55	$2,356.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $286.22 / $286.22 / $416.78	Facility		$286.22	$286.22	$416.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,186.86 / $1,454.85 / $1,454.85	Professional		$1,186.86	$1,454.85	$1,454.85
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 $321.62 / $629.16 / $2,422.73	Professional		$321.62	$629.16	$2,422.73
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $336.73 / $629.74 / $2,405.66	Professional		$336.73	$629.74	$2,405.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,232.13 / $1,638.25 / $2,227.73	Professional		$1,232.13	$1,638.25	$2,227.73
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 $1,500.85 / $2,051.08 / $3,105.71	Professional		$1,500.85	$2,051.08	$3,105.71