Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.12 / $84.54 / $197.85	Facility	26	$59.12	$84.54	$197.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.36 / $381.34 / $700.00	Professional		$222.36	$381.34	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.12 / $101.34 / $154.00	Professional	26	$59.12	$101.34	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.22 / $279.93 / $560.67	Professional	TC	$163.22	$279.93	$560.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.13 / $163.01 / $172.75	Professional		$150.13	$163.01	$172.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.18 / $46.82 / $85.52	Professional	26	$42.18	$46.82	$85.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $256.97 / $362.58 / $690.39	Professional		$256.97	$362.58	$690.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.72 / $67.55 / $124.28	Professional	26	$57.72	$67.55	$124.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $197.18 / $291.24 / $541.50	Professional	TC	$197.18	$291.24	$541.50
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $233.25 / $233.25 / $233.25	Professional		$233.25	$233.25	$233.25
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $63.07 / $63.07 / $63.07	Professional	26	$63.07	$63.07	$63.07
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $170.18 / $170.18 / $170.18	Professional	TC	$170.18	$170.18	$170.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $158.63 / $240.38	Professional		$58.80	$158.63	$240.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.86 / $64.84 / $64.84	Facility	26	$58.86	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.64 / $416.90 / $825.62	Professional		$209.64	$416.90	$825.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.28 / $76.87 / $131.60	Professional	26	$49.28	$76.87	$131.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $156.79 / $323.04 / $720.50	Professional	TC	$156.79	$323.04	$720.50
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $58.86 / $58.86 / $64.84	Facility	26	$58.86	$58.86	$64.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $209.64 / $405.22 / $823.80	Professional		$209.64	$405.22	$823.80
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $54.98 / $80.47 / $149.13	Professional	26	$54.98	$80.47	$149.13
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $158.63 / $286.92 / $696.81	Professional	TC	$158.63	$286.92	$696.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.46 / $183.60 / $277.73	Professional		$40.46	$183.60	$277.73
United Facility/Professional Professional Modifier Low / Median / High Price $225.09 / $320.02 / $629.79	Professional		$225.09	$320.02	$629.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $67.20 / $123.42	Professional	26	$51.28	$67.20	$123.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $168.70 / $243.36 / $544.92	Professional	TC	$168.70	$243.36	$544.92