Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $17.78 / $33.11	Facility	26	$12.30	$17.78	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $107.15 / $478.63	Professional		$46.77	$107.15	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $23.99 / $125.89	Professional	26	$12.02	$23.99	$125.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $13.80 / $21.88	Professional	26	$11.75	$13.80	$21.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $97.72 / $165.96	Professional		$57.54	$97.72	$165.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.49 / $26.30	Professional	26	$12.59	$15.49	$26.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $37.15 / $64.57	Professional		$12.30	$37.15	$64.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.88 / $13.49 / $19.05	Facility	26	$2.88	$13.49	$19.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $144.54	Professional		$42.66	$72.44	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $15.85 / $27.54	Professional	26	$10.00	$15.85	$27.54
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $2.88 / $13.49 / $19.05	Facility	26	$2.88	$13.49	$19.05
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $147.91	Professional		$41.69	$66.07	$147.91
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.85 / $30.20	Professional	26	$10.23	$15.85	$30.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $4.90 / $32.36 / $39.81	Professional		$4.90	$32.36	$39.81
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $54.95 / $100.00	Professional		$44.67	$54.95	$100.00
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $14.45 / $25.70	Professional	26	$11.75	$14.45	$25.70
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $114.82	Professional		$43.65	$61.66	$114.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.18 / $23.99	Professional	26	$10.00	$13.18	$23.99