Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.53 / $93.48 / $222.19	Facility	26	$66.53	$93.48	$222.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.78 / $380.29 / $815.24	Professional		$229.78	$380.29	$815.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.53 / $116.17 / $230.38	Professional	26	$66.53	$116.17	$230.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.84 / $281.41 / $557.00	Professional	TC	$163.84	$281.41	$557.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.34 / $173.14 / $204.18	Professional		$163.34	$173.14	$204.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.38 / $71.06 / $110.61	Professional	26	$47.38	$71.06	$110.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $191.89 / $191.89 / $191.89	Professional	TC	$191.89	$191.89	$191.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.39 / $365.54 / $653.94	Professional		$264.39	$365.54	$653.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.26 / $71.29 / $135.49	Professional	26	$48.26	$71.29	$135.49
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $393.48 / $538.67 / $980.91	Professional	50	$393.48	$538.67	$980.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $187.85 / $288.60 / $515.54	Professional	TC	$187.85	$288.60	$515.54
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $240.37 / $240.37 / $264.81	Professional		$240.37	$240.37	$264.81
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $70.93 / $70.93 / $78.14	Professional	26	$70.93	$70.93	$78.14
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $169.44 / $169.44 / $186.67	Professional	TC	$169.44	$169.44	$186.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.12 / $181.20 / $294.02	Professional		$66.12	$181.20	$294.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.08 / $72.95 / $72.95	Facility	26	$66.08	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.49 / $397.59 / $800.22	Professional		$216.49	$397.59	$800.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.44 / $85.95 / $147.72	Professional	26	$55.44	$85.95	$147.72
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $338.09 / $338.09 / $338.09	Professional	50	$338.09	$338.09	$338.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.47 / $313.77 / $644.41	Professional	TC	$157.47	$313.77	$644.41
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $66.08 / $66.08 / $72.95	Facility	26	$66.08	$66.08	$72.95
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $213.88 / $397.59 / $750.80	Professional		$213.88	$397.59	$750.80
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $61.72 / $92.94 / $168.33	Professional	26	$61.72	$92.94	$168.33
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $157.94 / $280.00 / $574.02	Professional	TC	$157.94	$280.00	$574.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $183.60 / $277.73	Professional		$40.54	$183.60	$277.73
United Facility/Professional Professional Modifier Low / Median / High Price $212.23 / $324.25 / $664.01	Professional		$212.23	$324.25	$664.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.73 / $74.56 / $135.58	Professional	26	$54.73	$74.56	$135.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.03 / $235.05 / $507.12	Professional	TC	$163.03	$235.05	$507.12