Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.64 / $53.29 / $104.04	Facility	26	$41.64	$53.29	$104.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.69 / $88.64 / $212.33	Professional		$51.69	$88.64	$212.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.28 / $41.64 / $88.28	Professional	26	$26.28	$41.64	$88.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.05 / $19.79 / $114.43	Professional	TC	$10.05	$19.79	$114.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.07 / $53.06 / $98.14	Professional		$37.07	$53.06	$98.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.90 / $40.65 / $67.06	Professional	26	$31.90	$40.65	$67.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $6.04 / $6.04 / $7.82	Professional	TC	$6.04	$6.04	$7.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.25 / $127.52 / $220.60	Professional		$71.25	$127.52	$220.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.57 / $40.47 / $67.95	Professional	26	$29.57	$40.47	$67.95
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $103.90 / $191.28 / $330.91	Professional	50	$103.90	$191.28	$330.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.53 / $94.02 / $158.51	Professional	TC	$14.53	$94.02	$158.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.42 / $49.28 / $69.91	Professional		$10.42	$49.28	$69.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.93 / $109.24 / $203.74	Professional		$54.93	$109.24	$203.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.35 / $46.54 / $69.91	Professional	26	$29.35	$46.54	$69.91
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $115.21 / $115.21 / $131.31	Professional	50	$115.21	$115.21	$131.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.42 / $44.82 / $147.97	Professional	TC	$10.42	$44.82	$147.97
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $55.71 / $96.66 / $208.88	Professional		$55.71	$96.66	$208.88
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $29.85 / $48.17 / $76.02	Professional	26	$29.85	$48.17	$76.02
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $10.89 / $39.54 / $153.58	Professional	TC	$10.89	$39.54	$153.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.77 / $64.17 / $98.91	Professional		$34.77	$64.17	$98.91
United Facility/Professional Professional Modifier Low / Median / High Price $63.24 / $90.01 / $148.05	Professional		$63.24	$90.01	$148.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.01 / $36.97 / $68.14	Professional	26	$26.01	$36.97	$68.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.15 / $55.14 / $103.29	Professional	TC	$28.15	$55.14	$103.29