Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.90 / $68.50 / $165.44	Facility	26	$47.90	$68.50	$165.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.78 / $171.00 / $414.36	Professional		$129.78	$171.00	$414.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $60.59 / $173.63	Professional	26	$44.14	$60.59	$173.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.87 / $122.80 / $314.14	Professional	TC	$81.87	$122.80	$314.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.95 / $101.30 / $124.87	Professional		$89.95	$101.30	$124.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.43 / $57.58 / $81.50	Professional	26	$35.43	$57.58	$81.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $134.96 / $134.96 / $134.96	Professional	TC	$134.96	$134.96	$134.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.43 / $236.87 / $438.32	Professional		$170.43	$236.87	$438.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $62.58 / $113.55	Professional	26	$52.46	$62.58	$113.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.09 / $177.58 / $328.52	Professional	TC	$101.09	$177.58	$328.52
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $140.63 / $140.63 / $154.93	Professional		$140.63	$140.63	$154.93
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $52.26 / $52.26 / $57.58	Professional	26	$52.26	$52.26	$57.58
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $88.37 / $88.37 / $97.36	Professional	TC	$88.37	$88.37	$97.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $97.36 / $164.55	Professional		$48.72	$97.36	$164.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.19 / $54.02 / $54.02	Facility	26	$49.19	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.23 / $232.15 / $437.55	Professional		$125.23	$232.15	$437.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.06 / $64.77 / $109.86	Professional	26	$41.06	$64.77	$109.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $80.94 / $157.26 / $323.52	Professional	TC	$80.94	$157.26	$323.52
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $49.19 / $49.19 / $54.02	Facility	26	$49.19	$49.19	$54.02
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $124.97 / $218.20 / $441.54	Professional		$124.97	$218.20	$441.54
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $47.01 / $70.87 / $144.47	Professional	26	$47.01	$70.87	$144.47
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $82.38 / $138.30 / $303.69	Professional	TC	$82.38	$138.30	$303.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $115.99 / $179.83	Professional		$40.43	$115.99	$179.83
United Facility/Professional Professional Modifier Low / Median / High Price $136.13 / $195.42 / $352.26	Professional		$136.13	$195.42	$352.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.68 / $58.74 / $103.36	Professional	26	$43.68	$58.74	$103.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.27 / $133.46 / $244.40	Professional	TC	$92.27	$133.46	$244.40