Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.25 / $374.40 / $11,581.00	Facility		$95.25	$374.40	$11,581.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.40 / $121.63 / $198.73	Professional		$86.40	$121.63	$198.73
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $221.07 / $221.07 / $221.07	Professional	50	$221.07	$221.07	$221.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,927.00 / $3,943.00	Facility		$937.00	$1,927.00	$3,943.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.73 / $117.52 / $211.96	Professional		$68.73	$117.52	$211.96
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $103.09 / $176.28 / $316.70	Professional	50	$103.09	$176.28	$316.70
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.64 / $95.57 / $149.33	Facility		$79.64	$95.57	$149.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.96 / $121.96 / $216.20	Professional		$121.96	$121.96	$216.20
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 $91.84 / $138.59 / $234.01	Professional		$91.84	$138.59	$234.01
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $95.56 / $144.69 / $234.01	Professional		$95.56	$144.69	$234.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $86.01 / $115.47 / $157.15	Professional		$86.01	$115.47	$157.15
United Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $1,952.00 / $4,132.00	Facility		$1,020.00	$1,952.00	$4,132.00
United Facility/Professional Professional Modifier Low / Median / High Price $108.72 / $148.60 / $244.68	Professional		$108.72	$148.60	$244.68