Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.95 / $45.69 / $107.67	Facility	26	$31.95	$45.69	$107.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.50 / $79.63 / $146.41	Professional		$70.50	$79.63	$146.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.07 / $34.20 / $70.52	Professional	26	$29.07	$34.20	$70.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.29 / $47.97 / $85.78	Professional	TC	$42.29	$47.97	$85.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.31 / $77.31 / $77.31	Professional		$77.31	$77.31	$77.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.58 / $30.92 / $47.30	Professional	26	$24.58	$30.92	$47.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.11 / $89.95 / $154.63	Professional		$68.11	$89.95	$154.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.73 / $38.58 / $68.56	Professional	26	$29.73	$38.58	$68.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $52.60 / $87.39	Professional	TC	$38.11	$52.60	$87.39
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $87.45 / $87.45 / $87.45	Professional		$87.45	$87.45	$87.45
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $36.99 / $36.99 / $36.99	Professional	26	$36.99	$36.99	$36.99
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $50.47 / $50.47 / $50.47	Professional	TC	$50.47	$50.47	$50.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $34.49 / $47.05 / $81.52	Professional		$34.49	$47.05	$81.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.76 / $104.66 / $172.96	Professional		$69.76	$104.66	$172.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $44.40 / $73.50	Professional	26	$28.84	$44.40	$73.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.89 / $60.70 / $103.90	Professional	TC	$39.89	$60.70	$103.90
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $73.38 / $104.10 / $167.10	Professional		$73.38	$104.10	$167.10
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $31.52 / $45.51 / $78.94	Professional	26	$31.52	$45.51	$78.94
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $41.72 / $60.70 / $95.80	Professional	TC	$41.72	$60.70	$95.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $48.67 / $131.21	Professional		$29.82	$48.67	$131.21
United Facility/Professional Professional Modifier Low / Median / High Price $69.05 / $90.83 / $159.09	Professional		$69.05	$90.83	$159.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.28 / $40.18 / $69.52	Professional	26	$29.28	$40.18	$69.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.21 / $51.73 / $89.35	Professional	TC	$38.21	$51.73	$89.35