Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.56 / $57.18 / $124.94	Facility	26	$34.56	$57.18	$124.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.67 / $143.56 / $289.44	Professional		$127.67	$143.56	$289.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.59 / $35.25 / $74.76	Professional	26	$28.59	$35.25	$74.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.52 / $107.36 / $207.79	Professional	TC	$94.52	$107.36	$207.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.61 / $47.43 / $61.71	Professional	26	$26.61	$47.43	$61.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.78 / $140.94 / $227.09	Professional		$111.78	$140.94	$227.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.28 / $44.64 / $76.77	Professional	26	$37.28	$44.64	$76.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.31 / $96.61 / $157.19	Professional	TC	$74.31	$96.61	$157.19
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $170.94 / $170.94 / $170.94	Professional		$170.94	$170.94	$170.94
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $44.04 / $44.04 / $44.04	Professional	26	$44.04	$44.04	$44.04
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $126.91 / $126.91 / $126.91	Professional	TC	$126.91	$126.91	$126.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.27 / $107.38 / $149.66	Professional		$37.27	$107.38	$149.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.05 / $184.09 / $294.54	Professional		$126.05	$184.09	$294.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.78 / $47.29 / $76.31	Professional	26	$32.78	$47.29	$76.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.62 / $136.40 / $218.66	Professional	TC	$91.62	$136.40	$218.66
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $126.05 / $184.09 / $294.45	Professional		$126.05	$184.09	$294.45
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $34.10 / $47.43 / $79.51	Professional	26	$34.10	$47.43	$79.51
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $95.66 / $136.66 / $218.66	Professional	TC	$95.66	$136.66	$218.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $126.16 / $221.83	Professional		$40.43	$126.16	$221.83
United Facility/Professional Professional Modifier Low / Median / High Price $116.19 / $167.20 / $268.95	Professional		$116.19	$167.20	$268.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.49 / $42.65 / $67.50	Professional	26	$30.49	$42.65	$67.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.08 / $123.41 / $203.68	Professional	TC	$84.08	$123.41	$203.68