Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $935.57 / $4,723.00 / $11,627.00	Facility		$935.57	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $935.57 / $935.57 / $1,880.26	Professional		$935.57	$935.57	$1,880.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,426.00 / $12,098.50 / $21,233.00	Facility		$4,426.00	$12,098.50	$21,233.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $728.34 / $1,001.68 / $1,729.97	Professional		$728.34	$1,001.68	$1,729.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $907.90 / $1,089.48 / $1,348.47	Facility		$907.90	$1,089.48	$1,348.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $818.25 / $998.69 / $998.69	Professional		$818.25	$998.69	$998.69
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 $767.63 / $1,271.06 / $1,911.61	Professional		$767.63	$1,271.06	$1,911.61
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $907.90 / $1,320.54 / $1,911.61	Professional		$907.90	$1,320.54	$1,911.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $115.77 / $868.73 / $1,288.94	Professional		$115.77	$868.73	$1,288.94
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 $874.04 / $1,186.63 / $2,012.56	Professional		$874.04	$1,186.63	$2,012.56