Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.19 / $27.44 / $69.37	Facility	26	$19.19	$27.44	$69.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $91.14 / $178.24	Professional		$73.73	$91.14	$178.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.50 / $19.92 / $41.76	Professional	26	$17.50	$19.92	$41.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.57 / $71.95 / $138.13	Professional	TC	$55.57	$71.95	$138.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.01 / $77.01 / $81.92	Professional		$77.01	$77.01	$81.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $26.52 / $31.39	Professional	26	$14.92	$26.52	$31.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.62 / $95.33 / $154.15	Professional		$75.62	$95.33	$154.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.79 / $40.56	Professional	26	$19.95	$23.79	$40.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.28 / $71.86 / $116.70	Professional	TC	$55.28	$71.86	$116.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.83 / $76.26 / $97.10	Professional		$20.83	$76.26	$97.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.72 / $22.72 / $24.65	Facility	26	$22.72	$22.72	$24.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.48 / $109.69 / $198.88	Professional		$78.48	$109.69	$198.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $26.76 / $43.70	Professional	26	$17.38	$26.76	$43.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.98 / $83.22 / $155.29	Professional	TC	$59.98	$83.22	$155.29
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $22.72 / $22.72 / $24.65	Facility	26	$22.72	$22.72	$24.65
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $80.89 / $110.33 / $185.36	Professional		$80.89	$110.33	$185.36
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $18.93 / $27.23 / $51.87	Professional	26	$18.93	$27.23	$51.87
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $62.38 / $84.58 / $145.59	Professional	TC	$62.38	$84.58	$145.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.25 / $90.42 / $140.42	Professional		$59.25	$90.42	$140.42
United Facility/Professional Professional Modifier Low / Median / High Price $73.88 / $102.11 / $179.55	Professional		$73.88	$102.11	$179.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.32 / $23.74 / $40.76	Professional	26	$17.32	$23.74	$40.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.95 / $75.12 / $131.87	Professional	TC	$50.95	$75.12	$131.87