Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.49 / $48.28 / $124.94	Facility	26	$34.49	$48.28	$124.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.69 / $142.66 / $460.00	Professional		$86.69	$142.66	$460.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.32 / $55.35 / $126.38	Professional	26	$33.32	$55.35	$126.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.83 / $64.31 / $110.97	Professional	TC	$50.83	$64.31	$110.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.67 / $72.33 / $121.47	Professional		$66.67	$72.33	$121.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.47 / $35.20 / $51.94	Professional	26	$26.47	$35.20	$51.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.89 / $39.86 / $53.48	Professional	TC	$33.89	$39.86	$53.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.55 / $108.42 / $174.68	Professional		$86.55	$108.42	$174.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.57 / $43.47 / $69.73	Professional	26	$34.57	$43.47	$69.73
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.98 / $62.37 / $103.72	Professional	TC	$51.98	$62.37	$103.72
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $91.69 / $108.36 / $152.53	Professional		$91.69	$108.36	$152.53
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $36.86 / $43.56 / $61.32	Professional	26	$36.86	$43.56	$61.32
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $54.82 / $64.79 / $91.21	Professional	TC	$54.82	$64.79	$91.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $64.79 / $113.46	Professional		$36.86	$64.79	$113.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.35 / $119.77 / $197.80	Professional		$83.35	$119.77	$197.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.79 / $47.43 / $75.45	Professional	26	$32.79	$47.43	$75.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.87 / $73.61 / $121.93	Professional	TC	$49.87	$73.61	$121.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $79.19 / $118.03 / $196.14	Professional		$79.19	$118.03	$196.14
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $34.45 / $52.45 / $96.34	Professional	26	$34.45	$52.45	$96.34
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $49.87 / $73.61 / $121.93	Professional	TC	$49.87	$73.61	$121.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $81.81 / $132.19	Professional		$40.43	$81.81	$132.19
United Facility/Professional Professional Modifier Low / Median / High Price $76.98 / $105.42 / $164.10	Professional		$76.98	$105.42	$164.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.57 / $43.48 / $76.52	Professional	26	$31.57	$43.48	$76.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.60 / $64.61 / $102.83	Professional	TC	$47.60	$64.61	$102.83