Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.40 / $36.95 / $94.89	Facility	26	$26.40	$36.95	$94.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.43 / $96.31 / $239.25	Professional		$53.43	$96.31	$239.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.82 / $35.04 / $86.99	Professional	26	$24.82	$35.04	$86.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.78 / $46.13 / $98.75	Professional	TC	$26.78	$46.13	$98.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.32 / $55.23 / $77.64	Professional		$45.32	$55.23	$77.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $27.20 / $43.01	Professional	26	$20.07	$27.20	$43.01
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.61 / $25.08 / $45.74	Professional	TC	$23.61	$25.08	$45.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.76 / $94.16 / $149.16	Professional		$72.76	$94.16	$149.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.09 / $35.14 / $53.72	Professional	26	$29.09	$35.14	$53.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.38 / $57.08 / $92.84	Professional	TC	$43.38	$57.08	$92.84
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $65.44 / $65.44 / $65.44	Professional		$65.44	$65.44	$65.44
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $30.62 / $30.62 / $30.62	Professional	26	$30.62	$30.62	$30.62
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $34.82 / $34.82 / $34.82	Professional	TC	$34.82	$34.82	$34.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.38 / $39.84 / $74.87	Professional		$28.38	$39.84	$74.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.25 / $87.23 / $163.89	Professional		$52.25	$87.23	$163.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.86 / $36.82 / $57.96	Professional	26	$24.86	$36.82	$57.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.40 / $47.21 / $110.66	Professional	TC	$26.40	$47.21	$110.66
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $52.72 / $83.35 / $165.00	Professional		$52.72	$83.35	$165.00
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $26.25 / $37.85 / $62.54	Professional	26	$26.25	$37.85	$62.54
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $26.75 / $43.16 / $110.70	Professional	TC	$26.75	$43.16	$110.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $48.49 / $88.82	Professional		$29.46	$48.49	$88.82
United Facility/Professional Professional Modifier Low / Median / High Price $51.83 / $68.15 / $119.82	Professional		$51.83	$68.15	$119.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.08 / $32.74 / $52.01	Professional	26	$24.08	$32.74	$52.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $35.29 / $78.04	Professional	TC	$25.57	$35.29	$78.04