Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $768.00 / $2,083.19 / $3,196.80	Facility		$768.00	$2,083.19	$3,196.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $768.00 / $768.00 / $2,188.80	Professional		$768.00	$768.00	$2,188.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,092.94 / $1,777.60 / $2,856.03	Facility		$1,092.94	$1,777.60	$2,856.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,076.72 / $1,142.41 / $1,688.00	Professional		$1,076.72	$1,142.41	$1,688.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.08 / $40.08 / $68.14	Facility		$40.08	$40.08	$68.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.08 / $40.08 / $40.08	Professional		$40.08	$40.08	$40.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $816.00 / $816.00 / $816.00	Facility		$816.00	$816.00	$816.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $816.00 / $816.00 / $1,335.22	Professional		$816.00	$816.00	$1,335.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $816.00 / $816.00 / $1,335.22	Professional		$816.00	$816.00	$1,335.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $1,256.65 / $1,428.01 / $1,656.49	Professional		$1,256.65	$1,428.01	$1,656.49
United Facility/Professional Professional Modifier Low / Median / High Price $800.00 / $800.00 / $1,124.00	Professional		$800.00	$800.00	$1,124.00