Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $791.25 / $4,723.00 / $11,627.00	Facility		$791.25	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $791.25 / $791.25 / $1,588.13	Professional		$791.25	$791.25	$1,588.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,965.67 / $4,089.29 / $7,640.32	Facility		$1,965.67	$4,089.29	$7,640.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $634.49 / $908.20 / $1,519.19	Professional		$634.49	$908.20	$1,519.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $840.53 / $1,009.12 / $1,576.74	Facility		$840.53	$1,009.12	$1,576.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $925.02 / $925.02 / $1,639.82	Professional		$925.02	$925.02	$1,639.82
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 $748.83 / $1,161.07 / $1,775.29	Professional		$748.83	$1,161.07	$1,775.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $829.30 / $1,178.31 / $1,775.29	Professional		$829.30	$1,178.31	$1,775.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $113.24 / $838.54 / $1,227.38	Professional		$113.24	$838.54	$1,227.38
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 $824.67 / $1,135.26 / $1,906.42	Professional		$824.67	$1,135.26	$1,906.42