Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,088.35 / $4,723.00 / $11,627.00	Facility		$1,088.35	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,046.00 / $1,088.35 / $2,180.16	Professional		$1,046.00	$1,088.35	$2,180.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,142.00 / $12,455.21 / $21,287.94	Facility		$4,142.00	$12,455.21	$21,287.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $851.27 / $1,143.71 / $1,979.16	Professional		$851.27	$1,143.71	$1,979.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,032.15 / $1,238.58 / $1,935.29	Facility		$1,032.15	$1,238.58	$1,935.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,135.36 / $1,135.36 / $2,012.70	Professional		$1,135.36	$1,135.36	$2,012.70
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 $956.03 / $1,417.90 / $2,174.91	Professional		$956.03	$1,417.90	$2,174.91
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,057.57 / $1,431.84 / $2,167.61	Professional		$1,057.57	$1,431.84	$2,167.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.29 / $942.19 / $1,466.95	Professional		$78.29	$942.19	$1,466.95
United Facility/Professional Facility Modifier Low / Median / High Price $1,480.00 / $3,086.00 / $6,111.00	Facility		$1,480.00	$3,086.00	$6,111.00
United Facility/Professional Professional Modifier Low / Median / High Price $993.39 / $1,374.85 / $2,427.98	Professional		$993.39	$1,374.85	$2,427.98