Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,575.00 / $8,956.00 / $12,096.23	Facility		$1,575.00	$8,956.00	$12,096.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $872.52 / $1,005.99 / $3,285.95	Professional		$872.52	$1,005.99	$3,285.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,084.00 / $4,437.00 / $19,117.00	Facility		$2,084.00	$4,437.00	$19,117.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $756.62 / $983.52 / $1,834.19	Professional		$756.62	$983.52	$1,834.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $971.52 / $1,414.66 / $1,414.66	Facility		$971.52	$1,414.66	$1,414.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $871.66 / $1,047.72 / $1,047.72	Professional		$871.66	$1,047.72	$1,047.72
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 $890.56 / $1,196.33 / $1,972.85	Professional		$890.56	$1,196.33	$1,972.85
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $933.42 / $1,268.51 / $1,972.85	Professional		$933.42	$1,268.51	$1,972.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.26 / $915.63 / $1,369.35	Professional		$69.26	$915.63	$1,369.35
United Facility/Professional Facility Modifier Low / Median / High Price $3,206.00 / $6,392.00 / $10,075.00	Facility		$3,206.00	$6,392.00	$10,075.00
United Facility/Professional Professional Modifier Low / Median / High Price $836.60 / $1,058.69 / $2,226.23	Professional		$836.60	$1,058.69	$2,226.23