Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $75.86 / $190.55	Facility	26	$53.70	$75.86	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $218.78 / $630.96	Professional		$177.83	$218.78	$630.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $323.59 / $501.19	Professional		$251.19	$323.59	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $549.54	Professional		$199.53	$302.00	$549.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $549.54	Professional		$199.53	$302.00	$549.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $489.78 / $489.78 / $489.78	Facility	26	$489.78	$489.78	$489.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $457.09	Professional		$213.80	$309.03	$457.09
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $446.68	Professional		$190.55	$263.03	$446.68