Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $114.82 / $245.47	Facility	26	$87.10	$114.82	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $354.81 / $912.01	Professional		$245.47	$354.81	$912.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $117.49 / $295.12	Professional	26	$75.86	$117.49	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $229.09 / $562.34	Professional	TC	$162.18	$229.09	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $239.88 / $316.23	Professional		$173.78	$239.88	$316.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $81.28 / $154.88	Professional	26	$64.57	$81.28	$154.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $346.74 / $588.84	Professional		$251.19	$346.74	$588.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $100.00 / $181.97	Professional	26	$67.61	$100.00	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $245.47 / $407.38	Professional	TC	$190.55	$245.47	$407.38
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Professional		$346.74	$346.74	$346.74
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	26	$100.00	$100.00	$100.00
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $251.19 / $251.19	Professional	TC	$251.19	$251.19	$251.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $141.25	Facility	26	$20.89	$97.72	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $467.74 / $870.96	Professional		$281.84	$467.74	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $114.82 / $199.53	Professional	26	$74.13	$114.82	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $323.59 / $676.08	Professional	TC	$204.17	$323.59	$676.08
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $141.25	Facility	26	$20.89	$97.72	$141.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $436.52 / $912.01	Professional		$275.42	$436.52	$912.01
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $112.20 / $229.09	Professional	26	$75.86	$112.20	$229.09
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $316.23 / $691.83	Professional	TC	$204.17	$316.23	$691.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $194.98	Professional		$32.36	$33.11	$194.98
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $234.42 / $489.78	Professional		$186.21	$234.42	$489.78
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $102.33 / $181.97	Professional	26	$81.28	$102.33	$181.97
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $131.83 / $288.40	Professional	TC	$107.15	$131.83	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $389.05 / $676.08	Professional		$275.42	$389.05	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $100.00 / $173.78	Professional	26	$74.13	$100.00	$173.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $275.42 / $501.19	Professional	TC	$190.55	$275.42	$501.19