Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.79 / $55.19 / $114.51	Facility	26	$36.79	$55.19	$114.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $116.45 / $224.91	Professional		$101.04	$116.45	$224.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $39.08 / $97.85	Professional	26	$29.91	$39.08	$97.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.14 / $80.54 / $155.88	Professional	TC	$71.14	$80.54	$155.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.98 / $89.98 / $89.98	Professional		$89.98	$89.98	$89.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.36 / $33.57 / $61.36	Professional	26	$28.36	$33.57	$61.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.29 / $107.83 / $185.15	Professional		$79.29	$107.83	$185.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.34 / $42.33 / $71.73	Professional	26	$34.34	$42.33	$71.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.95 / $63.69 / $111.78	Professional	TC	$44.95	$63.69	$111.78
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $141.91 / $141.91	Professional		$128.82	$141.91	$141.91
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $42.54 / $46.87 / $46.87	Professional	26	$42.54	$46.87	$46.87
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $86.28 / $95.06 / $95.06	Professional	TC	$86.28	$95.06	$95.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $92.28 / $152.84	Professional		$39.65	$92.28	$152.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.88 / $43.57 / $43.57	Facility	26	$40.88	$43.57	$43.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.96 / $147.35 / $273.00	Professional		$97.96	$147.35	$273.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.93 / $47.84 / $80.76	Professional	26	$31.93	$47.84	$80.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.02 / $98.11 / $181.28	Professional	TC	$66.02	$98.11	$181.28
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $40.88 / $40.88 / $43.57	Facility	26	$40.88	$40.88	$43.57
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $97.96 / $147.31 / $244.55	Professional		$97.96	$147.31	$244.55
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $35.42 / $49.91 / $85.97	Professional	26	$35.42	$49.91	$85.97
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $68.09 / $98.99 / $168.17	Professional	TC	$68.09	$98.99	$168.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.51 / $88.08 / $175.61	Professional		$40.51	$88.08	$175.61
United Facility/Professional Professional Modifier Low / Median / High Price $83.38 / $126.09 / $226.63	Professional		$83.38	$126.09	$226.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.43 / $42.73 / $75.45	Professional	26	$31.43	$42.73	$75.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.06 / $86.60 / $147.62	Professional	TC	$60.06	$86.60	$147.62