Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.18 / $50.86 / $81.91	Facility	26	$29.18	$50.86	$81.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.06 / $112.06 / $256.52	Professional		$81.06	$112.06	$256.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $44.56 / $76.42	Professional	26	$15.71	$44.56	$76.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.01 / $60.28 / $194.60	Professional	TC	$46.01	$60.28	$194.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.60 / $34.61 / $59.75	Professional	26	$25.60	$34.61	$59.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.75 / $211.87 / $386.46	Professional		$109.75	$211.87	$386.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.23 / $23.59 / $53.20	Professional	26	$18.23	$23.59	$53.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.52 / $192.37 / $355.71	Professional	TC	$58.52	$192.37	$355.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.54 / $63.09 / $119.74	Professional		$44.54	$63.09	$119.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.14 / $52.72 / $52.72	Facility	26	$20.14	$52.72	$52.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.95 / $138.66 / $460.37	Professional		$84.95	$138.66	$460.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $43.26 / $88.32	Professional	26	$19.80	$43.26	$88.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.68 / $89.93 / $435.47	Professional	TC	$44.68	$89.93	$435.47
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $20.14 / $20.14 / $52.72	Facility	26	$20.14	$20.14	$52.72
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $85.02 / $133.72 / $481.05	Professional		$85.02	$133.72	$481.05
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $21.15 / $47.59 / $90.85	Professional	26	$21.15	$47.59	$90.85
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $46.76 / $80.16 / $282.79	Professional	TC	$46.76	$80.16	$282.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.46 / $82.38 / $132.19	Professional		$40.46	$82.38	$132.19
United Facility/Professional Professional Modifier Low / Median / High Price $86.45 / $133.60 / $415.56	Professional		$86.45	$133.60	$415.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.27 / $49.10 / $89.64	Professional	26	$17.27	$49.10	$89.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.20 / $70.51 / $233.97	Professional	TC	$51.20	$70.51	$233.97