Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.74 / $79.42 / $202.45	Facility	26	$62.74	$79.42	$202.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $114.41 / $200.81	Professional		$103.20	$114.41	$200.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.79 / $65.04 / $119.01	Professional	26	$58.79	$65.04	$119.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.80 / $117.10 / $141.46	Professional		$93.80	$117.10	$141.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.38 / $71.38 / $84.88	Professional	26	$56.38	$71.38	$84.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.31 / $120.00 / $190.51	Professional		$89.31	$120.00	$190.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.73 / $67.28 / $106.97	Professional	26	$49.73	$67.28	$106.97
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $101.04 / $101.04	Professional		$101.04	$101.04	$101.04
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $60.63 / $60.63	Professional	26	$60.63	$60.63	$60.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.83 / $78.81 / $138.11	Professional		$46.83	$78.81	$138.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.17 / $74.17 / $74.17	Facility	26	$74.17	$74.17	$74.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.18 / $142.47 / $272.74	Professional		$94.18	$142.47	$272.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $88.79 / $175.85	Professional	26	$60.63	$88.79	$175.85
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $74.17 / $74.17 / $74.17	Facility	26	$74.17	$74.17	$74.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $102.81 / $150.52 / $241.39	Professional		$102.81	$150.52	$241.39
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $88.45 / $141.94	Professional	26	$60.63	$88.45	$141.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.14 / $68.99 / $118.83	Professional		$30.14	$68.99	$118.83
United Facility/Professional Professional Modifier Low / Median / High Price $102.42 / $150.29 / $261.20	Professional		$102.42	$150.29	$261.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.56 / $85.08 / $143.13	Professional	26	$57.56	$85.08	$143.13