Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.97 / $4,723.00 / $11,627.00	Facility		$113.97	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.97 / $113.97 / $246.55	Professional		$113.97	$113.97	$246.55
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 $100.55 / $137.22 / $254.59	Professional		$100.55	$137.22	$254.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.99 / $145.16 / $179.67	Facility		$117.99	$145.16	$179.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $122.02 / $133.07 / $133.07	Professional		$122.02	$133.07	$133.07
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 $133.07 / $176.71 / $264.70	Professional		$133.07	$176.71	$264.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $139.12 / $184.59 / $264.70	Professional		$139.12	$184.59	$264.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $119.28 / $159.46 / $212.56	Professional		$119.28	$159.46	$212.56
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 $121.11 / $172.19 / $300.77	Professional		$121.11	$172.19	$300.77