Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,215.66 / $7,155.00 / $24,818.47	Facility		$1,215.66	$7,155.00	$24,818.47
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $607.83 / $903.85 / $2,031.15	Facility	52	$607.83	$903.85	$2,031.15
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $243.13 / $361.54 / $812.46	Facility	53	$243.13	$361.54	$812.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,785.00 / $8,239.18 / $15,310.83	Facility		$2,785.00	$8,239.18	$15,310.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,164.11 / $1,396.94 / $1,729.02	Facility		$1,164.11	$1,396.94	$1,729.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $1,200.00 / $21,571.00	Facility		$425.00	$1,200.00	$21,571.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,091.32 / $1,091.32 / $1,091.32	Facility	52	$1,091.32	$1,091.32	$1,091.32
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $272.83 / $272.83 / $272.83	Facility	53	$272.83	$272.83	$272.83
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $136.41 / $136.41 / $136.41	Facility	AS	$136.41	$136.41	$136.41
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $425.00 / $600.00 / $1,391.39	Facility		$425.00	$600.00	$1,391.39
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $1,091.32 / $1,091.32 / $1,091.32	Facility	52	$1,091.32	$1,091.32	$1,091.32
Medical Mutual of Ohio Facility/Professional Facility Modifier 53 Low / Median / High Price $272.83 / $272.83 / $272.83	Facility	53	$272.83	$272.83	$272.83
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $136.41 / $136.41 / $136.41	Facility	AS	$136.41	$136.41	$136.41
United Facility/Professional Facility Modifier Low / Median / High Price $650.00 / $2,883.00 / $6,111.00	Facility		$650.00	$2,883.00	$6,111.00