Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $642.54 / $993.14 / $2,660.55	Facility		$642.54	$993.14	$2,660.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $642.54 / $1,075.95 / $1,903.12	Professional		$642.54	$1,075.95	$1,903.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $751.69 / $884.34 / $1,166.17	Professional		$751.69	$884.34	$1,166.17
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 $646.94 / $951.76 / $1,742.12	Professional		$646.94	$951.76	$1,742.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $761.41 / $951.76 / $1,130.89	Facility		$761.41	$951.76	$1,130.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,068.98 / $1,263.33 / $2,295.52	Professional		$1,068.98	$1,263.33	$2,295.52
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 $702.40 / $1,154.09 / $1,688.84	Professional		$702.40	$1,154.09	$1,688.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $761.41 / $1,199.15 / $1,738.21	Professional		$761.41	$1,199.15	$1,738.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $906.56 / $1,225.22 / $1,629.86	Professional		$906.56	$1,225.22	$1,629.86
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 $739.10 / $1,095.33 / $1,724.46	Professional		$739.10	$1,095.33	$1,724.46