Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $66.07 / $173.78	Facility	26	$53.70	$66.07	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $363.08 / $794.33	Professional		$309.03	$363.08	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $63.10 / $151.36	Professional	26	$51.29	$63.10	$151.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $331.13 / $660.69	Professional		$32.36	$331.13	$660.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $100.00	Professional	26	$52.48	$72.44	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $269.15 / $489.78	Professional		$181.97	$269.15	$489.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $64.57 / $104.71	Professional	26	$48.98	$64.57	$104.71
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $524.81 / $707.95	Professional		$457.09	$524.81	$707.95
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $85.11 / $114.82	Professional	26	$74.13	$85.11	$114.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $63.10 / $89.13	Facility	26	$13.49	$63.10	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $870.96	Professional		$275.42	$426.58	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $75.86 / $138.04	Professional	26	$52.48	$75.86	$138.04
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $63.10 / $89.13	Facility	26	$13.49	$63.10	$89.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $407.38 / $724.44	Professional		$251.19	$407.38	$724.44
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $75.86 / $134.90	Professional	26	$51.29	$75.86	$134.90
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 $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $436.52 / $812.83	Professional		$354.81	$436.52	$812.83
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $69.18 / $131.83	Professional	26	$58.88	$69.18	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $354.81 / $630.96	Professional		$223.87	$354.81	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $64.57 / $112.20	Professional	26	$47.86	$64.57	$112.20