Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.26 / $61.91 / $113.42	Facility	26	$47.26	$61.91	$113.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.45 / $142.82 / $290.61	Professional		$109.45	$142.82	$290.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $47.26 / $113.42	Professional	26	$29.91	$47.26	$113.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.54 / $99.05 / $197.70	Professional	TC	$79.54	$99.05	$197.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.24 / $36.70 / $48.15	Professional	26	$36.24	$36.70	$48.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.95 / $128.80 / $222.50	Professional		$89.95	$128.80	$222.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.34 / $44.56 / $76.05	Professional	26	$34.34	$44.56	$76.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.61 / $84.15 / $147.10	Professional	TC	$55.61	$84.15	$147.10
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $160.94 / $160.94 / $177.31	Professional		$160.94	$160.94	$177.31
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $54.14 / $54.14 / $59.64	Professional	26	$54.14	$54.14	$59.64
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $106.80 / $106.80 / $117.66	Professional	TC	$106.80	$106.80	$117.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.47 / $99.56 / $150.03	Professional		$50.47	$99.56	$150.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.49 / $55.98 / $55.98	Facility	26	$40.49	$55.98	$55.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.96 / $185.91 / $330.92	Professional		$119.96	$185.91	$330.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.50 / $53.01 / $102.18	Professional	26	$36.50	$53.01	$102.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.86 / $126.81 / $233.28	Professional	TC	$82.86	$126.81	$233.28
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $40.49 / $40.49 / $55.98	Facility	26	$40.49	$40.49	$55.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $124.78 / $179.57 / $303.35	Professional		$124.78	$179.57	$303.35
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $38.42 / $57.35 / $107.91	Professional	26	$38.42	$57.35	$107.91
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $88.86 / $129.01 / $230.77	Professional	TC	$88.86	$129.01	$230.77
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 $96.89 / $163.07 / $292.76	Professional		$96.89	$163.07	$292.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.27 / $54.60 / $100.80	Professional	26	$33.27	$54.60	$100.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.13 / $113.80 / $196.80	Professional	TC	$81.13	$113.80	$196.80