Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.08 / $55.83 / $113.42	Facility	26	$41.08	$55.83	$113.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.14 / $130.41 / $245.39	Professional		$109.14	$130.41	$245.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.19 / $45.86 / $107.10	Professional	26	$31.19	$45.86	$107.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $91.77 / $167.48	Professional	TC	$79.23	$91.77	$167.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.57 / $107.65 / $254.79	Professional		$101.57	$107.65	$254.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.08 / $41.47 / $60.09	Professional	26	$32.08	$41.47	$60.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.22 / $114.80 / $204.59	Professional		$79.22	$114.80	$204.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.34 / $43.07 / $72.81	Professional	26	$34.34	$43.07	$72.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.88 / $73.02 / $129.43	Professional	TC	$44.88	$73.02	$129.43
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $145.51 / $145.51 / $145.51	Professional		$145.51	$145.51	$145.51
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $47.06 / $47.06 / $47.06	Professional	26	$47.06	$47.06	$47.06
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $98.45 / $98.45 / $98.45	Professional	TC	$98.45	$98.45	$98.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.87 / $105.33 / $172.63	Professional		$43.87	$105.33	$172.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.49 / $48.64 / $48.64	Facility	26	$40.49	$48.64	$48.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.30 / $166.87 / $293.25	Professional		$109.30	$166.87	$293.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.09 / $48.93 / $88.08	Professional	26	$34.09	$48.93	$88.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.33 / $114.77 / $207.79	Professional	TC	$76.33	$114.77	$207.79
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $40.49 / $40.49 / $48.64	Facility	26	$40.49	$40.49	$48.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $111.23 / $166.24 / $276.22	Professional		$111.23	$166.24	$276.22
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $37.22 / $53.01 / $98.66	Professional	26	$37.22	$53.01	$98.66
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $79.08 / $116.32 / $191.90	Professional	TC	$79.08	$116.32	$191.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.51 / $117.26 / $181.19	Professional		$40.51	$117.26	$181.19
United Facility/Professional Professional Modifier Low / Median / High Price $90.77 / $140.75 / $260.77	Professional		$90.77	$140.75	$260.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.42 / $47.53 / $80.93	Professional	26	$31.42	$47.53	$80.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.03 / $101.28 / $179.21	Professional	TC	$69.03	$101.28	$179.21