Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $917.24 / $5,495.00 / $11,627.00	Facility		$917.24	$5,495.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $917.24 / $917.24 / $1,834.41	Professional		$917.24	$917.24	$1,834.41
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 $697.45 / $983.57 / $1,673.18	Professional		$697.45	$983.57	$1,673.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $973.84 / $1,168.60 / $1,446.41	Facility		$973.84	$1,168.60	$1,446.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $790.09 / $1,071.22 / $1,071.22	Professional		$790.09	$1,071.22	$1,071.22
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 $863.36 / $1,342.46 / $2,052.44	Professional		$863.36	$1,342.46	$2,052.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $958.32 / $1,363.38 / $2,052.44	Professional		$958.32	$1,363.38	$2,052.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $117.54 / $825.30 / $1,350.09	Professional		$117.54	$825.30	$1,350.09
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 $928.40 / $1,305.50 / $2,198.02	Professional		$928.40	$1,305.50	$2,198.02