Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $42.66 / $100.00	Facility	26	$30.20	$42.66	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $144.54	Professional		$79.43	$95.50	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $33.11 / $52.48	Professional	26	$28.18	$33.11	$52.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $158.49	Professional		$79.43	$100.00	$158.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $37.15 / $58.88	Professional	26	$28.84	$37.15	$58.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $37.15	Professional		$32.36	$32.36	$37.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $35.48 / $51.29	Facility	26	$7.59	$35.48	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $117.49 / $204.17	Professional		$85.11	$117.49	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $42.66 / $70.79	Professional	26	$30.90	$42.66	$70.79
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $35.48 / $51.29	Facility	26	$7.59	$35.48	$51.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $117.49 / $190.55	Professional		$83.18	$117.49	$190.55
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $41.69 / $69.18	Professional	26	$30.20	$41.69	$69.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $47.86	Professional		$32.36	$33.11	$47.86
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $162.18 / $162.18	Facility	26	$162.18	$162.18	$162.18
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $107.15 / $204.17	Professional		$91.20	$107.15	$204.17
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.02 / $70.79	Professional	26	$32.36	$38.02	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $97.72 / $162.18	Professional		$74.13	$97.72	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $36.31 / $60.26	Professional	26	$26.30	$36.31	$60.26