Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.49 / $667.03 / $11,581.00	Facility		$126.49	$667.03	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.99 / $192.32 / $362.20	Professional		$114.99	$192.32	$362.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.34 / $151.66 / $295.89	Professional		$93.34	$151.66	$295.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.61 / $133.93 / $165.77	Facility		$111.61	$133.93	$165.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.60 / $202.84 / $202.84	Professional		$158.60	$202.84	$202.84
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 $124.35 / $221.28 / $376.07	Professional		$124.35	$221.28	$376.07
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $133.93 / $226.97 / $377.60	Professional		$133.93	$226.97	$377.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $152.86 / $212.55 / $296.47	Professional		$152.86	$212.55	$296.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,952.00 / $4,132.00	Facility		$1,020.00	$1,952.00	$4,132.00
United Facility/Professional Professional Modifier Low / Median / High Price $179.26 / $249.63 / $418.61	Professional		$179.26	$249.63	$418.61