Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.91 / $88.53 / $210.58	Facility	26	$61.91	$88.53	$210.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.07 / $232.78 / $423.14	Professional		$160.07	$232.78	$423.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.25 / $75.53 / $183.64	Professional	26	$57.25	$75.53	$183.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.16 / $148.58 / $312.45	Professional	TC	$98.16	$148.58	$312.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.81 / $126.66 / $153.37	Professional		$120.81	$126.66	$153.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.09 / $73.64 / $94.91	Professional	26	$45.09	$73.64	$94.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $85.98 / $85.98 / $85.98	Professional	TC	$85.98	$85.98	$85.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.60 / $243.44 / $465.59	Professional		$190.60	$243.44	$465.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.69 / $72.12 / $129.10	Professional	26	$63.69	$72.12	$129.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $120.84 / $177.55 / $331.21	Professional	TC	$120.84	$177.55	$331.21
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $173.01 / $173.01 / $192.07	Professional		$173.01	$173.01	$192.07
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $67.56 / $67.56 / $75.01	Professional	26	$67.56	$67.56	$75.01
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $105.46 / $105.46 / $117.07	Professional	TC	$105.46	$105.46	$117.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.99 / $116.18 / $200.91	Professional		$62.99	$116.18	$200.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.72 / $69.79 / $69.79	Facility	26	$62.72	$69.79	$69.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.55 / $263.92 / $493.56	Professional		$155.55	$263.92	$493.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.06 / $81.56 / $137.78	Professional	26	$53.06	$81.56	$137.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.97 / $184.73 / $348.78	Professional	TC	$96.97	$184.73	$348.78
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $62.72 / $62.72 / $69.79	Facility	26	$62.72	$62.72	$69.79
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $153.96 / $251.21 / $457.34	Professional		$153.96	$251.21	$457.34
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $58.58 / $85.25 / $159.38	Professional	26	$58.58	$85.25	$159.38
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $98.30 / $166.56 / $348.67	Professional	TC	$98.30	$166.56	$348.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $116.44 / $179.83	Professional		$40.55	$116.44	$179.83
United Facility/Professional Professional Modifier Low / Median / High Price $177.09 / $230.36 / $434.48	Professional		$177.09	$230.36	$434.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.30 / $73.53 / $134.38	Professional	26	$50.30	$73.53	$134.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.03 / $165.50 / $304.11	Professional	TC	$115.03	$165.50	$304.11