Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,294.26 / $3,187.11 / $4,093.08	Facility		$1,294.26	$3,187.11	$4,093.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,294.26 / $1,294.26 / $3,598.04	Professional		$1,294.26	$1,294.26	$3,598.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.02 / $0.03 / $0.07	Facility		$0.02	$0.03	$0.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,429.07 / $1,429.07 / $2,267.21	Professional		$1,429.07	$1,429.07	$2,267.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $508.91 / $508.91 / $839.70	Facility		$508.91	$508.91	$839.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $508.91 / $508.91 / $508.91	Professional		$508.91	$508.91	$508.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,429.07 / $1,429.07 / $1,429.07	Facility		$1,429.07	$1,429.07	$1,429.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,429.07 / $1,429.07 / $2,163.62	Professional		$1,429.07	$1,429.07	$2,163.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,429.07 / $1,429.07 / $2,163.62	Professional		$1,429.07	$1,429.07	$2,163.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,571.97 / $1,786.33 / $2,072.15	Professional		$1,571.97	$1,786.33	$2,072.15
United Facility/Professional Professional Modifier Low / Median / High Price $1,388.63 / $1,388.63 / $1,501.94	Professional		$1,388.63	$1,388.63	$1,501.94