Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.34 / $39.10 / $98.33	Facility	26	$27.34	$39.10	$98.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.76 / $106.50 / $190.33	Professional		$93.76	$106.50	$190.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.33 / $29.66 / $67.15	Professional	26	$26.33	$29.66	$67.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.43 / $78.81 / $133.91	Professional	TC	$67.43	$78.81	$133.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.25 / $81.01 / $97.21	Professional		$76.25	$81.01	$97.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.79 / $22.83 / $40.50	Professional	26	$20.79	$22.83	$40.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.62 / $120.82 / $188.85	Professional		$99.62	$120.82	$188.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.69 / $34.77 / $54.26	Professional	26	$27.69	$34.77	$54.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.78 / $85.90 / $135.91	Professional	TC	$70.78	$85.90	$135.91
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $112.47 / $112.47 / $112.47	Professional		$112.47	$112.47	$112.47
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.69 / $31.69 / $31.69	Professional	26	$31.69	$31.69	$31.69
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $80.76 / $80.76 / $80.76	Professional	TC	$80.76	$80.76	$80.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $29.55 / $85.59 / $130.19	Professional		$29.55	$85.59	$130.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.25 / $133.31 / $215.82	Professional		$92.25	$133.31	$215.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.52 / $37.90 / $60.18	Professional	26	$25.52	$37.90	$60.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.79 / $95.20 / $152.77	Professional	TC	$65.79	$95.20	$152.77
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $93.84 / $133.43 / $216.15	Professional		$93.84	$133.43	$216.15
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $27.32 / $39.01 / $63.38	Professional	26	$27.32	$39.01	$63.38
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $66.88 / $95.82 / $153.31	Professional	TC	$66.88	$95.82	$153.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $88.08 / $175.61	Professional		$40.43	$88.08	$175.61
United Facility/Professional Professional Modifier Low / Median / High Price $86.52 / $117.95 / $186.16	Professional		$86.52	$117.95	$186.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.65 / $34.06 / $57.61	Professional	26	$24.65	$34.06	$57.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.51 / $84.62 / $132.18	Professional	TC	$63.51	$84.62	$132.18