Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,465.77 / $5,635.00 / $11,561.00	Facility		$1,465.77	$5,635.00	$11,561.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,158.61 / $1,465.77 / $2,946.27	Professional		$1,158.61	$1,465.77	$2,946.27
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 $959.11 / $1,355.51 / $2,343.21	Professional		$959.11	$1,355.51	$2,343.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,113.99 / $1,336.79 / $1,654.57	Facility		$1,113.99	$1,336.79	$1,654.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,098.58 / $1,541.75 / $1,541.75	Professional		$1,098.58	$1,541.75	$1,541.75
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 $1,170.55 / $1,726.68 / $2,634.49	Professional		$1,170.55	$1,726.68	$2,634.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,219.10 / $1,742.70 / $2,663.03	Professional		$1,219.10	$1,742.70	$2,663.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $150.57 / $1,264.61 / $2,053.62	Professional		$150.57	$1,264.61	$2,053.62
United Facility/Professional Facility Modifier Low / Median / High Price $3,206.00 / $6,578.00 / $10,075.00	Facility		$3,206.00	$6,578.00	$10,075.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,283.88 / $1,866.68 / $3,236.19	Professional		$1,283.88	$1,866.68	$3,236.19