Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $102.33 / $218.78	Facility	26	$72.44	$102.33	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $977.24	Professional		$194.98	$295.12	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $109.65 / $213.80	Professional	26	$64.57	$109.65	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $169.82 / $371.54	Professional	TC	$125.89	$169.82	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $60.26 / $67.61	Professional	26	$60.26	$60.26	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $302.00 / $501.19	Professional		$234.42	$302.00	$501.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $100.00 / $162.18	Professional	26	$77.62	$100.00	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $204.17 / $331.13	Professional	TC	$151.36	$204.17	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $85.11 / $123.03	Facility	26	$18.62	$85.11	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $316.23 / $537.03	Professional		$199.53	$316.23	$537.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $102.33 / $173.78	Professional	26	$64.57	$102.33	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $208.93 / $363.08	Professional	TC	$134.90	$208.93	$363.08
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $85.11 / $123.03	Facility	26	$18.62	$85.11	$123.03
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $562.34	Professional		$199.53	$309.03	$562.34
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $100.00 / $181.97	Professional	26	$64.57	$100.00	$181.97
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $199.53 / $371.54	Professional	TC	$128.82	$199.53	$371.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $125.89	Professional		$32.36	$33.11	$125.89
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	26	$295.12	$295.12	$295.12
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $309.03	Professional		$141.25	$173.78	$309.03
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $89.13 / $158.49	Professional	26	$70.79	$89.13	$158.49
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $85.11 / $151.36	Professional	TC	$69.18	$85.11	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $331.13 / $1,023.29	Professional		$213.80	$331.13	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $83.18 / $154.88	Professional	26	$63.10	$83.18	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $213.80 / $851.14	Professional	TC	$141.25	$213.80	$851.14