Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,388.29 / $4,856.00 / $11,627.00	Facility		$1,388.29	$4,856.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,388.29 / $1,388.29 / $4,182.39	Professional		$1,388.29	$1,388.29	$4,182.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,315.00 / $8,450.20 / $15,206.26	Facility		$3,315.00	$8,450.20	$15,206.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,060.66 / $1,407.67 / $2,319.78	Professional		$1,060.66	$1,407.67	$2,319.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,213.52 / $1,213.52 / $1,767.06	Facility		$1,213.52	$1,213.52	$1,767.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,308.64 / $1,308.70 / $1,308.70	Professional		$1,308.64	$1,308.70	$1,308.70
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 $1,237.32 / $1,706.48 / $2,471.96	Professional		$1,237.32	$1,706.48	$2,471.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,277.63 / $1,826.24 / $2,360.69	Professional		$1,277.63	$1,826.24	$2,360.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $107.95 / $1,242.08 / $1,746.32	Professional		$107.95	$1,242.08	$1,746.32
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 $1,278.45 / $1,647.49 / $2,563.01	Professional		$1,278.45	$1,647.49	$2,563.01