Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,715.20 / $7,818.92 / $12,520.22	Facility		$3,715.20	$7,818.92	$12,520.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,715.20 / $3,715.20 / $5,585.18	Professional		$3,715.20	$3,715.20	$5,585.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,067.78 / $3,433.85 / $9,055.79	Facility		$2,067.78	$3,433.85	$9,055.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $4,179.60 / $6,811.20 / $10,805.96	Professional		$4,179.60	$6,811.20	$10,805.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,402.60 / $5,402.60 / $9,184.42	Facility		$5,402.60	$5,402.60	$9,184.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.31 / $5,402.60 / $5,402.60	Professional		$106.31	$5,402.60	$5,402.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $3,947.40	Facility		$3,947.40	$3,947.40	$3,947.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $4,644.00	Professional		$3,947.40	$3,947.40	$4,644.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $3,947.40 / $3,947.40 / $4,644.00	Professional		$3,947.40	$3,947.40	$4,644.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $129.93 / $140.96 / $226.30	Professional		$129.93	$140.96	$226.30
United Facility/Professional Professional Modifier Low / Median / High Price $3,870.00 / $3,870.00 / $5,069.70	Professional		$3,870.00	$3,870.00	$5,069.70