Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $8,912.51 / $11,748.98	Facility		$1,584.89	$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 $1,318.26 / $1,348.96 / $1,737.80	Facility		$1,318.26	$1,348.96	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $1,584.89 / $2,398.83	Facility		$34.67	$1,584.89	$2,398.83
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,818.38 / $2,818.38 / $2,818.38	Facility	22	$2,818.38	$2,818.38	$2,818.38
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $426.58 / $2,398.83 / $21,379.62	Facility		$426.58	$2,398.83	$21,379.62
Medical Mutual of Ohio Facility/Professional Facility Modifier 22 Low / Median / High Price $2,818.38 / $2,818.38 / $2,818.38	Facility	22	$2,818.38	$2,818.38	$2,818.38
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