Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $8,912.51 / $11,748.98	Facility		$1,862.09	$8,912.51	$11,748.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $6,456.54 / $15,135.61	Facility		$1,698.24	$6,456.54	$15,135.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,621.81 / $2,041.74	Facility		$1,548.82	$1,621.81	$2,041.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $2,630.27 / $2,818.38	Facility		$34.67	$2,630.27	$2,818.38
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Facility	22	$3,388.44	$3,388.44	$3,388.44
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility	52	$2,238.72	$2,238.72	$2,238.72
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $281.84 / $281.84 / $281.84	Facility	AS	$281.84	$281.84	$281.84
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $2,818.38 / $21,379.62	Facility		$602.56	$2,818.38	$21,379.62
Medical Mutual of Ohio Facility/Professional Facility Modifier 22 Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Facility	22	$3,388.44	$3,388.44	$3,388.44
Medical Mutual of Ohio Facility/Professional Facility Modifier 52 Low / Median / High Price $2,238.72 / $2,238.72 / $2,238.72	Facility	52	$2,238.72	$2,238.72	$2,238.72
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $281.84 / $281.84 / $281.84	Facility	AS	$281.84	$281.84	$281.84
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