Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.06 / $75.00 / $146.41	Facility	26	$46.06	$75.00	$146.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.17 / $210.80 / $378.48	Professional		$117.17	$210.80	$378.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.16 / $78.90 / $146.41	Professional	26	$45.16	$78.90	$146.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.00 / $131.90 / $232.06	Professional	TC	$72.00	$131.90	$232.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.86 / $77.86 / $121.54	Professional		$77.86	$77.86	$121.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.14 / $45.35 / $59.75	Professional	26	$34.14	$45.35	$59.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.23 / $149.47 / $247.14	Professional		$118.23	$149.47	$247.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.65 / $51.74 / $82.69	Professional	26	$36.65	$51.74	$82.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.72 / $97.33 / $167.67	Professional	TC	$79.72	$97.33	$167.67
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $127.61 / $127.61 / $197.90	Professional		$127.61	$127.61	$197.90
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $50.36 / $50.36 / $78.09	Professional	26	$50.36	$50.36	$78.09
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $77.23 / $77.23 / $119.79	Professional	TC	$77.23	$77.23	$119.79
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.08 / $85.10 / $145.99	Professional		$50.08	$85.10	$145.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.20 / $289.39 / $513.26	Professional		$194.20	$289.39	$513.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.09 / $89.66 / $144.57	Professional	26	$72.09	$89.66	$144.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.11 / $181.97 / $414.02	Professional	TC	$122.11	$181.97	$414.02
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $283.13 / $1,307.59	Professional		$63.57	$283.13	$1,307.59
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $64.44 / $119.98	Professional	26	$45.36	$64.44	$119.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.02 / $91.36 / $180.57	Professional		$41.02	$91.36	$180.57
United Facility/Professional Professional Modifier Low / Median / High Price $108.54 / $145.99 / $241.63	Professional		$108.54	$145.99	$241.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.32 / $50.96 / $88.06	Professional	26	$36.32	$50.96	$88.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.68 / $92.15 / $166.28	Professional	TC	$66.68	$92.15	$166.28