Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,438.98 / $4,197.00 / $10,635.00	Facility		$1,438.98	$4,197.00	$10,635.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $967.71 / $967.71 / $3,129.20	Professional		$967.71	$967.71	$3,129.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,009.00 / $4,142.00 / $19,117.00	Facility		$2,009.00	$4,142.00	$19,117.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $819.22 / $1,158.33 / $1,903.99	Professional		$819.22	$1,158.33	$1,903.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $892.40 / $1,070.88 / $1,325.45	Facility		$892.40	$1,070.88	$1,325.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $981.64 / $981.64 / $1,174.74	Professional		$981.64	$981.64	$1,174.74
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 $756.44 / $1,346.04 / $1,919.89	Professional		$756.44	$1,346.04	$1,919.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $892.40 / $1,369.83 / $1,894.00	Professional		$892.40	$1,369.83	$1,894.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.97 / $917.68 / $1,299.81	Professional		$115.97	$917.68	$1,299.81
United Facility/Professional Facility Modifier Low / Median / High Price $2,840.00 / $5,998.00 / $7,847.00	Facility		$2,840.00	$5,998.00	$7,847.00
United Facility/Professional Professional Modifier Low / Median / High Price $887.94 / $1,204.74 / $2,006.60	Professional		$887.94	$1,204.74	$2,006.60