Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.99 / $64.52 / $143.47	Facility	26	$38.99	$64.52	$143.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.40 / $156.00 / $413.47	Professional		$99.40	$156.00	$413.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.74 / $62.57 / $192.00	Professional	26	$37.74	$62.57	$192.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.82 / $69.69 / $128.80	Professional	TC	$56.82	$69.69	$128.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.80 / $84.58 / $118.01	Professional		$70.80	$84.58	$118.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.31 / $40.26 / $53.05	Professional	26	$30.31	$40.26	$53.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $51.38 / $64.90 / $90.68	Professional	TC	$51.38	$64.90	$90.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.39 / $100.53 / $167.05	Professional		$70.39	$100.53	$167.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $44.66 / $73.93	Professional	26	$29.59	$44.66	$73.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.79 / $54.52 / $94.06	Professional	TC	$40.79	$54.52	$94.06
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $108.17 / $127.84 / $179.96	Professional		$108.17	$127.84	$179.96
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $41.68 / $49.26 / $69.34	Professional	26	$41.68	$49.26	$69.34
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $66.50 / $78.59 / $110.62	Professional	TC	$66.50	$78.59	$110.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.68 / $78.59 / $133.85	Professional		$41.68	$78.59	$133.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.92 / $135.69 / $223.25	Professional		$91.92	$135.69	$223.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.02 / $53.04 / $85.29	Professional	26	$36.02	$53.04	$85.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.08 / $83.42 / $140.41	Professional	TC	$55.08	$83.42	$140.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $91.60 / $136.66 / $219.34	Professional		$91.60	$136.66	$219.34
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $38.79 / $57.87 / $106.11	Professional	26	$38.79	$57.87	$106.11
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $57.43 / $85.58 / $147.41	Professional	TC	$57.43	$85.58	$147.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $81.89 / $132.19	Professional		$40.43	$81.89	$132.19
United Facility/Professional Professional Modifier Low / Median / High Price $84.77 / $120.19 / $196.61	Professional		$84.77	$120.19	$196.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.19 / $47.94 / $77.05	Professional	26	$35.19	$47.94	$77.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.61 / $76.41 / $122.06	Professional	TC	$52.61	$76.41	$122.06