Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.10 / $37.97 / $90.27	Facility	26	$25.10	$37.97	$90.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.59 / $101.59 / $209.52	Professional		$87.59	$101.59	$209.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.14 / $27.39 / $56.68	Professional	26	$24.14	$27.39	$56.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.70 / $73.73 / $140.53	Professional	TC	$64.70	$73.73	$140.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.08 / $81.63 / $101.21	Professional		$62.08	$81.63	$101.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.14 / $23.93 / $38.04	Professional	26	$19.14	$23.93	$38.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.37 / $107.24 / $173.52	Professional		$89.37	$107.24	$173.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.39 / $29.99 / $45.12	Professional	26	$24.39	$29.99	$45.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.77 / $90.50 / $135.44	Professional	TC	$58.77	$90.50	$135.44
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $113.33 / $113.33 / $113.33	Professional		$113.33	$113.33	$113.33
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $28.78 / $28.78 / $28.78	Professional	26	$28.78	$28.78	$28.78
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $84.55 / $84.55 / $84.55	Professional	TC	$84.55	$84.55	$84.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.83 / $89.64 / $131.13	Professional		$26.83	$89.64	$131.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.24 / $125.65 / $205.52	Professional		$91.24	$125.65	$205.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.90 / $34.72 / $55.80	Professional	26	$23.90	$34.72	$55.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.87 / $89.56 / $153.32	Professional	TC	$65.87	$89.56	$153.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $93.09 / $124.85 / $201.68	Professional		$93.09	$124.85	$201.68
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $24.97 / $35.92 / $58.75	Professional	26	$24.97	$35.92	$58.75
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $69.23 / $90.82 / $148.62	Professional	TC	$69.23	$90.82	$148.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $86.99 / $175.61	Professional		$40.43	$86.99	$175.61
United Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $121.32 / $194.61	Professional		$84.57	$121.32	$194.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $31.23 / $49.45	Professional	26	$22.91	$31.23	$49.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.40 / $88.32 / $144.84	Professional	TC	$60.40	$88.32	$144.84