Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $77.62 / $199.53	Facility	26	$53.70	$77.62	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $173.78 / $416.87	Professional		$102.33	$173.78	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $109.65 / $144.54	Professional		$97.72	$109.65	$144.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $151.36 / $234.42	Professional		$117.49	$151.36	$234.42
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $151.36 / $218.78	Professional		$123.03	$151.36	$218.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $141.25	Professional		$52.48	$72.44	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $234.42	Professional		$102.33	$147.91	$234.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $144.54 / $239.88	Professional		$97.72	$144.54	$239.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $48.98	Professional		$32.36	$33.11	$48.98
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $257.04	Professional		$114.82	$147.91	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $128.82 / $204.17	Professional		$97.72	$128.82	$204.17