Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.71 / $56.99 / $140.02	Facility	26	$40.71	$56.99	$140.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.66 / $171.00 / $362.34	Professional		$106.66	$171.00	$362.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $45.55 / $131.40	Professional	26	$37.99	$45.55	$131.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.95 / $105.92 / $282.80	Professional	TC	$65.95	$105.92	$282.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.67 / $83.65 / $110.17	Professional		$80.67	$83.65	$110.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.98 / $48.60 / $69.86	Professional	26	$29.98	$48.60	$69.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $108.92 / $108.92 / $108.92	Professional	TC	$108.92	$108.92	$108.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.73 / $184.24 / $353.09	Professional		$127.73	$184.24	$353.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.74 / $47.86 / $85.59	Professional	26	$42.74	$47.86	$85.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.65 / $138.93 / $270.02	Professional	TC	$78.65	$138.93	$270.02
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $116.12 / $116.12 / $127.93	Professional		$116.12	$116.12	$127.93
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $44.80 / $44.80 / $49.36	Professional	26	$44.80	$44.80	$49.36
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $71.33 / $71.33 / $78.59	Professional	TC	$71.33	$71.33	$78.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.77 / $78.59 / $134.85	Professional		$41.77	$78.59	$134.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $45.92 / $45.92	Facility	26	$41.65	$45.92	$45.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.33 / $167.30 / $339.54	Professional		$103.33	$167.30	$339.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $54.61 / $91.00	Professional	26	$34.90	$54.61	$91.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.37 / $108.89 / $235.81	Professional	TC	$63.37	$108.89	$235.81
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $45.92	Facility	26	$41.65	$41.65	$45.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.63 / $165.32 / $333.25	Professional		$89.63	$165.32	$333.25
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $39.76 / $63.17 / $118.14	Professional	26	$39.76	$63.17	$118.14
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $63.47 / $102.24 / $228.50	Professional	TC	$63.47	$102.24	$228.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $81.89 / $131.17	Professional		$40.43	$81.89	$131.17
United Facility/Professional Professional Modifier Low / Median / High Price $101.58 / $147.58 / $274.20	Professional		$101.58	$147.58	$274.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.29 / $49.19 / $87.76	Professional	26	$36.29	$49.19	$87.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.71 / $86.62 / $180.19	Professional	TC	$63.71	$86.62	$180.19