Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $906.13 / $4,723.00 / $11,627.00	Facility		$906.13	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $906.13 / $906.13 / $1,797.59	Professional		$906.13	$906.13	$1,797.59
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 $717.37 / $1,029.64 / $1,720.94	Professional		$717.37	$1,029.64	$1,720.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $958.52 / $1,154.28 / $1,428.67	Facility		$958.52	$1,154.28	$1,428.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $848.19 / $1,058.08 / $1,058.08	Professional		$848.19	$1,058.08	$1,058.08
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 $859.17 / $1,263.15 / $2,033.22	Professional		$859.17	$1,263.15	$2,033.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $907.11 / $1,293.81 / $2,033.22	Professional		$907.11	$1,293.81	$2,033.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $114.26 / $832.34 / $1,366.87	Professional		$114.26	$832.34	$1,366.87
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 $887.40 / $1,260.25 / $2,260.41	Professional		$887.40	$1,260.25	$2,260.41