Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.38 / $4,723.00 / $11,627.00	Facility		$90.38	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.38 / $90.38 / $212.94	Professional		$90.38	$90.38	$212.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.00 / $1,398.00 / $2,170.00	Facility		$937.00	$1,398.00	$2,170.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.33 / $139.02 / $230.85	Professional		$98.33	$139.02	$230.85
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.91 / $128.53 / $159.08	Facility		$106.91	$128.53	$159.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.82 / $117.82 / $131.61	Professional		$117.82	$117.82	$131.61
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 $112.35 / $151.72 / $224.93	Professional		$112.35	$151.72	$224.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $117.82 / $152.62 / $225.20	Professional		$117.82	$152.62	$225.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $119.28 / $159.46 / $212.56	Professional		$119.28	$159.46	$212.56
United Facility/Professional Facility Modifier Low / Median / High Price $444.00 / $979.00 / $3,218.00	Facility		$444.00	$979.00	$3,218.00
United Facility/Professional Professional Modifier Low / Median / High Price $101.82 / $143.41 / $242.26	Professional		$101.82	$143.41	$242.26