Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $8,912.51 / $12,022.64	Facility		$1,548.82	$8,912.51	$12,022.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,388.44 / $12,302.69 / $30,199.52	Facility		$3,388.44	$12,302.69	$30,199.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,479.11 / $1,737.80	Facility		$1,445.44	$1,479.11	$1,737.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,659.59 / $21,379.62	Facility		$1,202.26	$1,659.59	$21,379.62
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
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 $1,479.11 / $3,090.30 / $6,760.83	Facility		$1,479.11	$3,090.30	$6,760.83