Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,247.19 / $5,135.00 / $11,627.00	Facility		$1,247.19	$5,135.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,247.19 / $1,247.19 / $2,472.21	Professional		$1,247.19	$1,247.19	$2,472.21
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 $1,008.00 / $1,345.81 / $2,389.61	Professional		$1,008.00	$1,345.81	$2,389.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,184.58 / $1,421.51 / $1,759.43	Facility		$1,184.58	$1,421.51	$1,759.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,303.05 / $1,303.05 / $1,353.06	Professional		$1,303.05	$1,303.05	$1,353.06
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 $1,004.28 / $1,658.43 / $2,544.04	Professional		$1,004.28	$1,658.43	$2,544.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,124.47 / $1,778.38 / $2,457.98	Professional		$1,124.47	$1,778.38	$2,457.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.97 / $1,221.31 / $1,715.79	Professional		$115.97	$1,221.31	$1,715.79
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 $1,192.29 / $1,612.11 / $2,784.70	Professional		$1,192.29	$1,612.11	$2,784.70