Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $21.38 / $48.98	Facility	26	$14.79	$21.38	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $173.78	Professional		$64.57	$93.33	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.13 / $32.36	Professional	26	$12.02	$14.13	$32.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $81.28 / $138.04	Professional		$60.26	$81.28	$138.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.89 / $33.11	Professional	26	$15.85	$20.89	$33.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $104.71 / $194.98	Professional		$70.79	$104.71	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.95 / $33.11	Professional	26	$12.88	$19.95	$33.11
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $104.71 / $199.53	Professional		$69.18	$104.71	$199.53
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $19.95 / $35.48	Professional	26	$12.59	$19.95	$35.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $120.23 / $213.80	Professional		$97.72	$120.23	$213.80
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.50 / $34.67	Professional	26	$15.85	$19.50	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $85.11 / $151.36	Professional		$61.66	$85.11	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $16.60 / $28.18	Professional	26	$12.02	$16.60	$28.18