Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,513.56 / $8,912.51 / $11,748.98	Facility		$1,513.56	$8,912.51	$11,748.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $6,309.57 / $15,135.61	Facility		$1,698.24	$6,309.57	$15,135.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $1,318.26 / $1,659.59	Facility		$1,288.25	$1,318.26	$1,659.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $2,137.96 / $2,290.87	Facility		$34.67	$2,137.96	$2,290.87
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility	22	$2,754.23	$2,754.23	$2,754.23
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility	52	$1,819.70	$1,819.70	$1,819.70
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $229.09 / $229.09 / $229.09	Facility	AS	$229.09	$229.09	$229.09
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $2,290.87 / $21,379.62	Facility		$602.56	$2,290.87	$21,379.62
Medical Mutual of Ohio Facility/Professional Facility Modifier 22 Low / Median / High Price $2,754.23 / $2,754.23 / $2,754.23	Facility	22	$2,754.23	$2,754.23	$2,754.23
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility	52	$1,819.70	$1,819.70	$1,819.70
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $229.09 / $229.09 / $229.09	Facility	AS	$229.09	$229.09	$229.09
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 $575.44 / $2,691.53 / $6,760.83	Facility		$575.44	$2,691.53	$6,760.83