Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,375.78 / $5,535.00 / $11,627.00	Facility		$1,375.78	$5,535.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,375.78 / $1,375.78 / $2,733.91	Professional		$1,375.78	$1,375.78	$2,733.91
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 $1,160.36 / $1,638.78 / $2,656.91	Professional		$1,160.36	$1,638.78	$2,656.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,304.83 / $1,565.80 / $1,938.01	Facility		$1,304.83	$1,565.80	$1,938.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,435.31 / $1,435.31 / $1,616.23	Professional		$1,435.31	$1,435.31	$1,616.23
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 $1,105.74 / $1,901.18 / $2,813.34	Professional		$1,105.74	$1,901.18	$2,813.34
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,294.11 / $1,987.60 / $2,718.19	Professional		$1,294.11	$1,987.60	$2,718.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.97 / $1,374.45 / $1,946.53	Professional		$115.97	$1,374.45	$1,946.53
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 $1,336.38 / $1,761.52 / $3,081.58	Professional		$1,336.38	$1,761.52	$3,081.58