Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $25.12 / $60.26	Facility	26	$18.20	$25.12	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $138.04	Professional		$70.79	$95.50	$138.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $42.66 / $109.65	Professional		$30.90	$42.66	$109.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.68 / $21.88 / $31.62	Facility	26	$4.68	$21.88	$31.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $97.72 / $204.17	Professional		$44.67	$97.72	$204.17
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $4.68 / $21.88 / $31.62	Facility	26	$4.68	$21.88	$31.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $97.72 / $190.55	Professional		$46.77	$97.72	$190.55
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 $87.10 / $102.33 / $204.17	Professional		$87.10	$102.33	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $95.50 / $173.78	Professional		$47.86	$95.50	$173.78