Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,336.82 / $4,723.00 / $11,627.00	Facility		$1,336.82	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,289.11 / $1,336.82 / $2,355.42	Professional		$1,289.11	$1,336.82	$2,355.42
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 $1,098.23 / $1,539.49 / $2,472.01	Professional		$1,098.23	$1,539.49	$2,472.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,232.79 / $1,479.35 / $1,831.02	Facility		$1,232.79	$1,479.35	$1,831.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,356.07 / $1,356.07 / $1,476.13	Professional		$1,356.07	$1,356.07	$1,476.13
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 $1,044.39 / $1,764.04 / $2,662.97	Professional		$1,044.39	$1,764.04	$2,662.97
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,228.77 / $1,884.12 / $2,572.90	Professional		$1,228.77	$1,884.12	$2,572.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.97 / $1,248.65 / $1,797.03	Professional		$115.97	$1,248.65	$1,797.03
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 $1,190.79 / $1,606.03 / $2,918.96	Professional		$1,190.79	$1,606.03	$2,918.96