Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,645.41 / $2,540.89 / $4,294.52	Facility		$1,645.41	$2,540.89	$4,294.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,645.41 / $1,645.41 / $1,748.25	Professional		$1,645.41	$1,645.41	$1,748.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $866.53 / $1,439.00 / $4,010.69	Facility		$866.53	$1,439.00	$4,010.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,365.59 / $1,638.72 / $2,594.64	Professional		$1,365.59	$1,638.72	$2,594.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,413.86 / $1,413.86 / $1,748.25	Facility		$1,413.86	$1,413.86	$1,748.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,413.86 / $1,413.86 / $1,413.86	Professional		$1,413.86	$1,413.86	$1,413.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,748.25 / $1,748.25 / $1,748.25	Facility		$1,748.25	$1,748.25	$1,748.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,748.25 / $1,748.25 / $2,056.76	Professional		$1,748.25	$1,748.25	$2,056.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,748.25 / $1,748.25 / $2,619.63	Professional		$1,748.25	$1,748.25	$2,619.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $50.00 / $60.00	Professional		$40.00	$50.00	$60.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,713.97 / $1,713.97 / $2,127.04	Professional		$1,713.97	$1,713.97	$2,127.04