Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3.72 / $7.76 / $61.66	Facility		$3.72	$7.76	$61.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $50.12 / $123.03	Facility	26	$42.66	$50.12	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $44.67 / $128.82	Professional		$15.14	$44.67	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $43.65 / $128.82	Professional	26	$16.98	$43.65	$128.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Professional	26	$45.71	$45.71	$45.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $57.54 / $123.03	Professional		$15.85	$57.54	$123.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $21.38 / $54.95	Professional	26	$17.38	$21.38	$54.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.47 / $45.71 / $60.26	Facility		$3.47	$45.71	$60.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.02 / $45.71 / $102.33	Professional		$3.02	$45.71	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2.09 / $2.09 / $32.36	Facility		$2.09	$2.09	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Professional	26	$40.74	$40.74	$40.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2.75 / $3.24 / $32.36	Facility		$2.75	$3.24	$32.36
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $40.74 / $46.77	Professional	26	$40.74	$40.74	$46.77
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 Professional Modifier Low / Median / High Price $45.71 / $56.23 / $104.71	Professional		$45.71	$56.23	$104.71
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $52.48 / $100.00	Professional	26	$42.66	$52.48	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $22.91 / $53.70	Professional		$16.98	$22.91	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $22.39 / $50.12	Professional	26	$16.98	$22.39	$50.12