Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $758.58 / $1,096.48 / $3,630.78	Facility		$758.58	$1,096.48	$3,630.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $6,456.54 / $6,456.54	Facility		$6,456.54	$6,456.54	$6,456.54
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $6,456.54 / $6,456.54	Facility		$6,456.54	$6,456.54	$6,456.54
Molina Facility/Professional Facility Modifier Low / Median / High Price $5,248.07 / $8,912.51 / $14,454.40	Facility		$5,248.07	$8,912.51	$14,454.40
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,089.30	Facility		$2,089.30	$2,089.30	$2,089.30