Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.90 / $67.05 / $165.44	Facility	26	$47.90	$67.05	$165.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.64 / $151.37 / $353.10	Professional		$63.64	$151.37	$353.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.07 / $59.86 / $165.44	Professional	26	$45.07	$59.86	$165.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $204.97 / $204.97 / $204.97	Professional	50	$204.97	$204.97	$204.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.19 / $131.91 / $313.39	Professional	TC	$82.19	$131.91	$313.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.00 / $101.55 / $137.38	Professional		$98.00	$101.55	$137.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.97 / $46.06 / $77.51	Professional	26	$34.97	$46.06	$77.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.19 / $225.85 / $432.78	Professional		$163.19	$225.85	$432.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $59.32 / $107.30	Professional	26	$52.46	$59.32	$107.30
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $243.95 / $338.77 / $651.86	Professional	50	$243.95	$338.77	$651.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.39 / $170.00 / $314.50	Professional	TC	$101.39	$170.00	$314.50
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $140.97 / $140.97 / $140.97	Professional		$140.97	$140.97	$140.97
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $52.26 / $52.26 / $52.26	Professional	26	$52.26	$52.26	$52.26
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $88.71 / $88.71 / $88.71	Professional	TC	$88.71	$88.71	$88.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $97.73 / $165.20	Professional		$48.72	$97.73	$165.20
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 $125.45 / $225.12 / $415.60	Professional		$125.45	$225.12	$415.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.06 / $64.22 / $107.30	Professional	26	$41.06	$64.22	$107.30
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $231.80 / $231.80 / $231.80	Professional	50	$231.80	$231.80	$231.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.25 / $154.12 / $312.66	Professional	TC	$81.25	$154.12	$312.66
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 $125.29 / $218.73 / $405.66	Professional		$125.29	$218.73	$405.66
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $44.92 / $70.48 / $130.86	Professional	26	$44.92	$70.48	$130.86
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $82.70 / $138.83 / $288.39	Professional	TC	$82.70	$138.83	$288.39
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 $135.54 / $187.55 / $346.17	Professional		$135.54	$187.55	$346.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.93 / $58.94 / $115.03	Professional	26	$43.93	$58.94	$115.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.76 / $139.03 / $240.56	Professional	TC	$92.76	$139.03	$240.56