Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.24 / $85.73 / $209.40	Facility	26	$61.24	$85.73	$209.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.93 / $303.77 / $591.64	Professional		$228.93	$303.77	$591.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.78 / $74.70 / $197.95	Professional	26	$56.78	$74.70	$197.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.43 / $220.61 / $480.98	Professional	TC	$170.43	$220.61	$480.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.82 / $182.96 / $437.94	Professional		$173.82	$182.96	$437.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.72 / $66.89 / $93.88	Professional	26	$44.72	$66.89	$93.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.88 / $286.83 / $494.23	Professional		$245.88	$286.83	$494.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.29 / $72.00 / $128.29	Professional	26	$64.29	$72.00	$128.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $175.50 / $215.11 / $376.23	Professional	TC	$175.50	$215.11	$376.23
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $248.78 / $248.78 / $276.19	Professional		$248.78	$248.78	$276.19
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $66.84 / $66.84 / $74.20	Professional	26	$66.84	$66.84	$74.20
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $181.94 / $181.94 / $201.99	Professional	TC	$181.94	$181.94	$201.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $194.61 / $295.16	Professional		$62.30	$194.61	$295.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.36 / $69.05 / $69.05	Facility	26	$62.36	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.02 / $326.79 / $611.62	Professional		$220.02	$326.79	$611.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $80.97 / $137.00	Professional	26	$52.48	$80.97	$137.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $159.90 / $244.94 / $463.11	Professional	TC	$159.90	$244.94	$463.11
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $62.36 / $62.36 / $69.05	Facility	26	$62.36	$62.36	$69.05
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $214.23 / $324.62 / $590.34	Professional		$214.23	$324.62	$590.34
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $59.47 / $85.25 / $164.09	Professional	26	$59.47	$85.25	$164.09
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $159.90 / $240.33 / $448.42	Professional	TC	$159.90	$240.33	$448.42
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 $213.02 / $281.31 / $487.75	Professional		$213.02	$281.31	$487.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.94 / $73.68 / $131.12	Professional	26	$53.94	$73.68	$131.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.55 / $217.98 / $371.72	Professional	TC	$152.55	$217.98	$371.72