Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.77 / $79.75 / $192.04	Facility	26	$55.77	$79.75	$192.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.85 / $260.76 / $508.94	Professional		$221.85	$260.76	$508.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.45 / $67.50 / $179.29	Professional	26	$51.45	$67.50	$179.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.42 / $203.21 / $402.70	Professional	TC	$164.42	$203.21	$402.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $170.36 / $170.60 / $218.28	Professional		$170.36	$170.60	$218.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.26 / $67.04 / $90.25	Professional	26	$41.26	$67.04	$90.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $240.82 / $240.82 / $240.82	Professional	TC	$240.82	$240.82	$240.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $240.71 / $277.07 / $482.63	Professional		$240.71	$277.07	$482.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.32 / $65.31 / $116.37	Professional	26	$58.32	$65.31	$116.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $176.22 / $212.80 / $376.23	Professional	TC	$176.22	$212.80	$376.23
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $244.19 / $244.19 / $378.70	Professional		$244.19	$244.19	$378.70
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $60.85 / $60.85 / $94.37	Professional	26	$60.85	$60.85	$94.37
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $183.34 / $183.34 / $284.33	Professional	TC	$183.34	$183.34	$284.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $196.11 / $289.72	Professional		$56.73	$196.11	$289.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.09 / $62.89 / $62.89	Facility	26	$57.09	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.00 / $315.12 / $581.79	Professional		$215.00	$315.12	$581.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.80 / $74.17 / $123.94	Professional	26	$47.80	$74.17	$123.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.53 / $242.38 / $443.37	Professional	TC	$160.53	$242.38	$443.37
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $57.09 / $57.09 / $62.89	Facility	26	$57.09	$57.09	$62.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $209.91 / $313.22 / $576.41	Professional		$209.91	$313.22	$576.41
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $52.28 / $76.23 / $144.38	Professional	26	$52.28	$76.23	$144.38
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $160.53 / $239.05 / $440.10	Professional	TC	$160.53	$239.05	$440.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $196.97 / $313.88	Professional		$40.55	$196.97	$313.88
United Facility/Professional Professional Modifier Low / Median / High Price $208.22 / $277.99 / $474.19	Professional		$208.22	$277.99	$474.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.31 / $66.25 / $121.93	Professional	26	$50.31	$66.25	$121.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.96 / $217.39 / $373.16	Professional	TC	$156.96	$217.39	$373.16