Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,935.24 / $7,162.45 / $11,627.00	Facility		$1,935.24	$7,162.45	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,935.24 / $1,935.24 / $3,980.85	Professional		$1,935.24	$1,935.24	$3,980.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $6,813.00 / $17,502.61 / $31,496.21	Facility		$6,813.00	$17,502.61	$31,496.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,636.90 / $2,263.28 / $3,871.47	Professional		$1,636.90	$2,263.28	$3,871.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,029.35 / $2,461.66 / $3,046.83	Facility		$2,029.35	$2,461.66	$3,046.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,950.99 / $2,256.52 / $2,256.52	Professional		$1,950.99	$2,256.52	$2,256.52
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 $1,802.36 / $2,853.17 / $4,366.54	Professional		$1,802.36	$2,853.17	$4,366.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $2,024.29 / $2,897.25 / $4,366.54	Professional		$2,024.29	$2,897.25	$4,366.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $236.73 / $1,773.24 / $2,915.80	Professional		$236.73	$1,773.24	$2,915.80
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 $2,040.06 / $2,820.48 / $4,711.50	Professional		$2,040.06	$2,820.48	$4,711.50