Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.24 / $42.54 / $109.95	Facility	26	$31.24	$42.54	$109.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.48 / $155.34 / $367.04	Professional		$118.48	$155.34	$367.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.09 / $35.70 / $100.85	Professional	26	$29.09	$35.70	$100.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.83 / $100.06 / $189.78	Professional	TC	$85.83	$100.06	$189.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.00 / $144.88 / $177.87	Professional		$130.00	$144.88	$177.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.00 / $25.80 / $42.49	Professional	26	$24.00	$25.80	$42.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.09 / $129.12 / $206.34	Professional		$92.09	$129.12	$206.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.28 / $40.71 / $64.59	Professional	26	$34.28	$40.71	$64.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.81 / $85.37 / $152.46	Professional	TC	$57.81	$85.37	$152.46
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $207.34 / $207.34 / $279.38	Professional		$207.34	$207.34	$279.38
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $35.81 / $35.81 / $48.26	Professional	26	$35.81	$35.81	$48.26
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $171.51 / $171.51 / $231.11	Professional	TC	$171.51	$171.51	$231.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.39 / $174.85 / $245.99	Professional		$33.39	$174.85	$245.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.98 / $192.69 / $330.97	Professional		$116.98	$192.69	$330.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.15 / $42.81 / $68.64	Professional	26	$29.15	$42.81	$68.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.09 / $148.05 / $270.58	Professional	TC	$78.09	$148.05	$270.58
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $108.22 / $193.28 / $324.43	Professional		$108.22	$193.28	$324.43
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $44.01 / $71.87	Professional	26	$30.90	$44.01	$71.87
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $86.53 / $159.88 / $270.20	Professional	TC	$86.53	$159.88	$270.20
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 $103.18 / $159.88 / $275.74	Professional		$103.18	$159.88	$275.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.49 / $37.82 / $60.58	Professional	26	$28.49	$37.82	$60.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.70 / $125.59 / $209.03	Professional	TC	$71.70	$125.59	$209.03