Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $20.95 / $53.10	Facility	26	$14.65	$20.95	$53.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.75 / $68.13 / $160.65	Professional		$56.75	$68.13	$160.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $20.05 / $41.46	Professional	26	$13.70	$20.05	$41.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.39 / $50.38 / $99.24	Professional	TC	$42.39	$50.38	$99.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.22 / $55.04 / $66.68	Professional		$48.22	$55.04	$66.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $19.92 / $24.17	Professional	26	$11.39	$19.92	$24.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.95 / $71.70 / $117.10	Professional		$57.95	$71.70	$117.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.74 / $18.50 / $32.10	Professional	26	$15.74	$18.50	$32.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.45 / $52.93 / $86.53	Professional	TC	$42.45	$52.93	$86.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.65 / $61.12 / $88.51	Professional		$15.65	$61.12	$88.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $18.93	Facility	26	$17.32	$17.32	$18.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.63 / $82.14 / $145.33	Professional		$56.63	$82.14	$145.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $20.16 / $34.22	Professional	26	$13.23	$20.16	$34.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.54 / $61.21 / $114.68	Professional	TC	$43.54	$61.21	$114.68
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $18.93	Facility	26	$17.32	$17.32	$18.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $57.77 / $81.70 / $139.41	Professional		$57.77	$81.70	$139.41
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $14.70 / $21.08 / $42.21	Professional	26	$14.70	$21.08	$42.21
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $44.83 / $61.83 / $102.81	Professional	TC	$44.83	$61.83	$102.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.04 / $72.59 / $102.15	Professional		$53.04	$72.59	$102.15
United Facility/Professional Professional Modifier Low / Median / High Price $49.20 / $72.45 / $128.04	Professional		$49.20	$72.45	$128.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $18.23 / $31.77	Professional	26	$13.14	$18.23	$31.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.81 / $52.84 / $97.54	Professional	TC	$40.81	$52.84	$97.54