Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.68 / $46.18 / $90.17	Facility	26	$25.68	$46.18	$90.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.99 / $121.55 / $234.94	Professional		$92.99	$121.55	$234.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $25.68 / $47.42	Professional	26	$22.74	$25.68	$47.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.48 / $95.87 / $193.71	Professional	TC	$73.48	$95.87	$193.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.21 / $93.21 / $93.21	Professional		$93.21	$93.21	$93.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $25.38 / $29.76	Professional	26	$20.32	$25.38	$29.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.18 / $116.05 / $198.87	Professional		$87.18	$116.05	$198.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.63 / $32.44 / $56.48	Professional	26	$26.63	$32.44	$56.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.55 / $82.28 / $145.36	Professional	TC	$60.55	$82.28	$145.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $99.88 / $127.66	Professional		$27.78	$99.88	$127.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $32.22	Facility	26	$30.37	$30.37	$32.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.36 / $143.90 / $266.85	Professional		$100.36	$143.90	$266.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.25 / $35.46 / $59.62	Professional	26	$23.25	$35.46	$59.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.58 / $108.96 / $203.39	Professional	TC	$75.58	$108.96	$203.39
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $32.22	Facility	26	$30.37	$30.37	$32.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $98.23 / $143.90 / $249.54	Professional		$98.23	$143.90	$249.54
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $25.24 / $35.83 / $58.07	Professional	26	$25.24	$35.83	$58.07
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $78.95 / $111.97 / $192.81	Professional	TC	$78.95	$111.97	$192.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.51 / $117.26 / $181.19	Professional		$40.51	$117.26	$181.19
United Facility/Professional Professional Modifier Low / Median / High Price $83.88 / $122.34 / $232.45	Professional		$83.88	$122.34	$232.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.88 / $31.64 / $53.91	Professional	26	$22.88	$31.64	$53.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.48 / $95.72 / $171.97	Professional	TC	$66.48	$95.72	$171.97