Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $678.70 / $2,849.00 / $9,496.00	Facility		$678.70	$2,849.00	$9,496.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,621.03 / $5,737.50 / $5,737.50	Facility	50	$2,621.03	$5,737.50	$5,737.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $456.42 / $672.44 / $1,222.42	Professional		$456.42	$672.44	$1,222.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,152.00 / $2,894.00 / $8,800.00	Facility		$1,152.00	$2,894.00	$8,800.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $399.84 / $649.02 / $1,148.27	Professional		$399.84	$649.02	$1,148.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $463.14 / $555.77 / $868.40	Facility		$463.14	$555.77	$868.40
CareSource Facility/Professional Professional Modifier Low / Median / High Price $743.81 / $743.81 / $1,318.58	Professional		$743.81	$743.81	$1,318.58
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 $483.88 / $743.81 / $1,303.39	Professional		$483.88	$743.81	$1,303.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $727.26 / $727.26 / $1,969.25	Facility		$727.26	$727.26	$1,969.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $491.10 / $797.51 / $1,316.85	Professional		$491.10	$797.51	$1,316.85
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.30 / $602.78 / $972.32	Professional		$38.30	$602.78	$972.32
United Facility/Professional Facility Modifier Low / Median / High Price $2,647.00 / $4,410.00 / $7,351.00	Facility		$2,647.00	$4,410.00	$7,351.00
United Facility/Professional Professional Modifier Low / Median / High Price $616.15 / $868.32 / $1,493.00	Professional		$616.15	$868.32	$1,493.00