Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.31 / $100.56 / $243.28	Facility	26	$70.31	$100.56	$243.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.62 / $156.68 / $332.91	Professional		$134.62	$156.68	$332.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.80 / $80.87 / $199.88	Professional	26	$57.80	$80.87	$199.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.55 / $87.81 / $213.12	Professional	TC	$67.55	$87.81	$213.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $98.65 / $98.65	Professional		$95.50	$98.65	$98.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.60 / $84.94 / $108.30	Professional	26	$51.60	$84.94	$108.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.29 / $163.72 / $315.43	Professional		$139.29	$163.72	$315.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.75 / $69.15 / $116.37	Professional	26	$57.75	$69.15	$116.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.91 / $104.14 / $202.40	Professional	TC	$73.91	$104.14	$202.40
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $136.94 / $136.94 / $136.94	Professional		$136.94	$136.94	$136.94
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $77.09 / $77.09 / $77.09	Professional	26	$77.09	$77.09	$77.09
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $59.85 / $59.85 / $59.85	Professional	TC	$59.85	$59.85	$59.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $86.58 / $158.62	Professional		$56.28	$86.58	$158.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $86.79	Facility	26	$79.31	$79.31	$86.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.86 / $188.20 / $396.77	Professional		$122.86	$188.20	$396.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.50 / $81.67 / $146.36	Professional	26	$57.50	$81.67	$146.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.80 / $93.28 / $261.14	Professional	TC	$55.80	$93.28	$261.14
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $86.79	Facility	26	$79.31	$79.31	$86.79
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.89 / $183.70 / $378.75	Professional		$123.89	$183.70	$378.75
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $63.95 / $86.24 / $157.94	Professional	26	$63.95	$86.24	$157.94
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $58.33 / $92.95 / $223.91	Professional	TC	$58.33	$92.95	$223.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.24 / $97.80 / $180.04	Professional		$60.24	$97.80	$180.04
United Facility/Professional Professional Modifier Low / Median / High Price $124.03 / $174.71 / $307.48	Professional		$124.03	$174.71	$307.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.32 / $82.06 / $145.49	Professional	26	$49.32	$82.06	$145.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.39 / $85.65 / $189.16	Professional	TC	$61.39	$85.65	$189.16