Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.01 / $40.61 / $105.32	Facility	26	$29.01	$40.61	$105.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.24 / $125.23 / $488.86	Professional		$91.24	$125.23	$488.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.77 / $41.92 / $112.00	Professional	26	$28.77	$41.92	$112.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.98 / $84.53 / $143.47	Professional	TC	$62.98	$84.53	$143.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.30 / $76.56 / $100.89	Professional		$61.30	$76.56	$100.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.43 / $29.87 / $52.41	Professional	26	$22.43	$29.87	$52.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $49.33 / $52.42 / $90.00	Professional	TC	$49.33	$52.42	$90.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.36 / $108.23 / $166.92	Professional		$86.36	$108.23	$166.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $31.34 / $37.72 / $59.54	Professional	26	$31.34	$37.72	$59.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.52 / $71.00 / $105.44	Professional	TC	$54.52	$71.00	$105.44
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $106.38 / $106.38 / $117.20	Professional		$106.38	$106.38	$117.20
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $33.61 / $33.61 / $37.02	Professional	26	$33.61	$33.61	$37.02
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $72.77 / $72.77 / $80.17	Professional	TC	$72.77	$72.77	$80.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.33 / $77.09 / $123.26	Professional		$31.33	$77.09	$123.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.94 / $119.93 / $215.90	Professional		$80.94	$119.93	$215.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.06 / $40.24 / $63.80	Professional	26	$27.06	$40.24	$63.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.79 / $80.55 / $150.96	Professional	TC	$49.79	$80.55	$150.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $80.01 / $117.66 / $220.27	Professional		$80.01	$117.66	$220.27
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $28.80 / $42.56 / $70.95	Professional	26	$28.80	$42.56	$70.95
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $53.22 / $80.17 / $157.82	Professional	TC	$53.22	$80.17	$157.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.30 / $81.81 / $132.19	Professional		$40.30	$81.81	$132.19
United Facility/Professional Professional Modifier Low / Median / High Price $82.26 / $114.31 / $191.62	Professional		$82.26	$114.31	$191.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.86 / $34.93 / $57.15	Professional	26	$25.86	$34.93	$57.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.33 / $79.05 / $125.99	Professional	TC	$48.33	$79.05	$125.99