Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $54.95 / $114.82	Facility	26	$47.86	$54.95	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $245.47	Professional		$89.13	$123.03	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $50.12 / $117.49	Professional	26	$33.11	$50.12	$117.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $38.90 / $66.07	Professional	26	$35.48	$38.90	$66.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $107.15 / $173.78	Professional		$81.28	$107.15	$173.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $48.98 / $79.43	Professional	26	$35.48	$48.98	$79.43
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Professional		$131.83	$131.83	$131.83
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Professional	26	$61.66	$61.66	$61.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $54.95 / $79.43	Facility	26	$11.75	$54.95	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $134.90 / $251.19	Professional		$85.11	$134.90	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $53.70 / $95.50	Professional	26	$33.88	$53.70	$95.50
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $54.95 / $79.43	Facility	26	$11.75	$54.95	$79.43
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $125.89 / $251.19	Professional		$83.18	$125.89	$251.19
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $53.70 / $95.50	Professional	26	$33.11	$53.70	$95.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.88	Professional		$32.36	$33.11	$33.88
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility	26	$1,949.84	$1,949.84	$1,949.84
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $131.83 / $234.42	Professional		$107.15	$131.83	$234.42
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $58.88 / $109.65	Professional	26	$48.98	$58.88	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $199.53	Professional		$72.44	$114.82	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $38.90 / $67.61	Professional	26	$28.84	$38.90	$67.61