Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $9,120.11 / $11,748.98	Facility		$1,122.02	$9,120.11	$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 $954.99 / $1,000.00 / $1,230.27	Facility		$954.99	$1,000.00	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $1,698.24 / $1,698.24	Facility		$34.67	$1,698.24	$1,698.24
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Facility	22	$2,041.74	$2,041.74	$2,041.74
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	AS	$169.82	$169.82	$169.82
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $1,698.24 / $21,379.62	Facility		$426.58	$1,698.24	$21,379.62
Medical Mutual of Ohio Facility/Professional Facility Modifier 22 Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Facility	22	$2,041.74	$2,041.74	$2,041.74
Medical Mutual of Ohio Facility/Professional Facility Modifier AS Low / Median / High Price $169.82 / $169.82 / $169.82	Facility	AS	$169.82	$169.82	$169.82
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