Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $848.31 / $4,723.00 / $11,627.00	Facility		$848.31	$4,723.00	$11,627.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $848.31 / $848.31 / $1,692.49	Professional		$848.31	$848.31	$1,692.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,405.00 / $7,949.51 / $14,996.00	Facility		$3,405.00	$7,949.51	$14,996.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $705.04 / $1,012.54 / $1,671.59	Professional		$705.04	$1,012.54	$1,671.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $901.12 / $1,081.33 / $1,338.40	Facility		$901.12	$1,081.33	$1,338.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $841.24 / $991.23 / $991.23	Professional		$841.24	$991.23	$991.23
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 $799.06 / $1,227.17 / $1,900.42	Professional		$799.06	$1,227.17	$1,900.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $865.00 / $1,261.56 / $1,900.42	Professional		$865.00	$1,261.56	$1,900.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $117.78 / $784.14 / $1,287.21	Professional		$117.78	$784.14	$1,287.21
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 $864.86 / $1,215.32 / $2,034.31	Professional		$864.86	$1,215.32	$2,034.31