Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $564.62 / $3,999.00 / $10,268.00	Facility		$564.62	$3,999.00	$10,268.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,621.04 / $2,621.04 / $2,621.04	Facility	50	$2,621.04	$2,621.04	$2,621.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $438.78 / $551.58 / $1,003.88	Professional		$438.78	$551.58	$1,003.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,145.00 / $2,792.00 / $8,800.00	Facility		$1,145.00	$2,792.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $347.22 / $517.67 / $978.53	Professional		$347.22	$517.67	$978.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $563.32 / $690.60 / $1,289.18	Facility		$563.32	$690.60	$1,289.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $457.51 / $649.95 / $1,013.93	Professional		$457.51	$649.95	$1,013.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $778.50 / $949.77 / $21,571.00	Facility		$778.50	$949.77	$21,571.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $433.32 / $634.70 / $1,119.30	Professional		$433.32	$634.70	$1,119.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $949.77 / $949.77 / $1,059.09	Facility		$949.77	$949.77	$1,059.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $433.32 / $649.99 / $1,004.91	Professional		$433.32	$649.99	$1,004.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.13 / $381.00 / $671.47	Professional		$75.13	$381.00	$671.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $4,072.00 / $6,522.00	Facility		$1,981.00	$4,072.00	$6,522.00
United Facility/Professional Professional Modifier Low / Median / High Price $477.70 / $600.87 / $1,254.48	Professional		$477.70	$600.87	$1,254.48