Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.64 / $45.28 / $107.62	Facility	26	$29.64	$45.28	$107.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.78 / $122.89 / $378.55	Professional		$75.78	$122.89	$378.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $50.83 / $119.09	Professional	26	$29.23	$50.83	$119.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.91 / $60.06 / $103.78	Professional	TC	$44.91	$60.06	$103.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.60 / $65.19 / $105.63	Professional		$58.60	$65.19	$105.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.28 / $29.68 / $45.11	Professional	26	$23.28	$29.68	$45.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $47.45 / $62.22 / $62.22	Professional	TC	$47.45	$62.22	$62.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.08 / $100.63 / $162.96	Professional		$82.08	$100.63	$162.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.27 / $40.45 / $63.67	Professional	26	$33.27	$40.45	$63.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.81 / $57.51 / $99.32	Professional	TC	$48.81	$57.51	$99.32
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $80.67 / $86.54 / $112.50	Professional		$80.67	$86.54	$112.50
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $32.01 / $34.34 / $44.64	Professional	26	$32.01	$34.34	$44.64
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $48.66 / $52.20 / $67.86	Professional	TC	$48.66	$52.20	$67.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.01 / $57.51 / $99.79	Professional		$32.01	$57.51	$99.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.94 / $105.94 / $169.34	Professional		$72.94	$105.94	$169.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.52 / $41.16 / $64.84	Professional	26	$28.52	$41.16	$64.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.10 / $65.66 / $107.76	Professional	TC	$44.10	$65.66	$107.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $72.81 / $104.21 / $169.34	Professional		$72.81	$104.21	$169.34
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $29.92 / $43.58 / $82.47	Professional	26	$29.92	$43.58	$82.47
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $44.24 / $65.54 / $109.26	Professional	TC	$44.24	$65.54	$109.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $48.62 / $131.63	Professional		$29.46	$48.62	$131.63
United Facility/Professional Professional Modifier Low / Median / High Price $69.47 / $92.87 / $146.26	Professional		$69.47	$92.87	$146.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.56 / $35.78 / $58.39	Professional	26	$26.56	$35.78	$58.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.86 / $56.94 / $90.50	Professional	TC	$41.86	$56.94	$90.50