Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $636.59 / $1,469.45 / $5,522.18	Facility		$636.59	$1,469.45	$5,522.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $655.69 / $2,640.00	Professional		$636.59	$655.69	$2,640.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $687.52 / $1,111.80 / $1,827.01	Facility		$687.52	$1,111.80	$1,827.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $1,209.52	Professional		$636.59	$636.59	$1,209.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $636.59 / $636.59 / $1,082.20	Facility		$636.59	$636.59	$1,082.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $859.40	Professional		$636.59	$636.59	$859.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $600.55 / $600.55 / $636.59	Facility		$600.55	$600.55	$636.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $2,407.25	Professional		$636.59	$636.59	$2,407.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $2,407.25	Professional		$636.59	$636.59	$2,407.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $660.72 / $766.44 / $929.09	Professional		$660.72	$766.44	$929.09
United Facility/Professional Professional Modifier Low / Median / High Price $636.59 / $636.59 / $828.84	Professional		$636.59	$636.59	$828.84