Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $3,019.95 / $12,022.64	Facility		$223.87	$3,019.95	$12,022.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $131.83	Facility		$112.20	$112.20	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $21,379.62	Facility		$194.98	$194.98	$21,379.62
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $954.99 / $3,019.95	Facility		$457.09	$954.99	$3,019.95