Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.13 / $63.12 / $371.52	Facility	26	$37.13	$63.12	$371.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.08 / $121.54 / $247.23	Professional		$58.08	$121.54	$247.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $49.33 / $98.66	Professional	26	$34.46	$49.33	$98.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.76 / $88.25 / $151.87	Professional	TC	$75.76	$88.25	$151.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.84 / $96.59 / $104.77	Professional		$81.84	$96.59	$104.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.87 / $46.19 / $63.14	Professional	26	$28.87	$46.19	$63.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $64.31 / $64.31 / $83.15	Professional	TC	$64.31	$64.31	$83.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.47 / $140.26 / $252.29	Professional		$107.47	$140.26	$252.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $43.58 / $76.63	Professional	26	$33.22	$43.58	$76.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.23 / $97.56 / $174.28	Professional	TC	$74.23	$97.56	$174.28
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $134.12 / $134.12 / $208.00	Professional		$134.12	$134.12	$208.00
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $42.57 / $42.57 / $66.03	Professional	26	$42.57	$42.57	$66.03
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $91.54 / $91.54 / $141.97	Professional	TC	$91.54	$91.54	$141.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.69 / $97.69 / $159.12	Professional		$39.69	$97.69	$159.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $47.86	Facility	26	$43.97	$43.97	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.82 / $164.46 / $269.47	Professional		$110.82	$164.46	$269.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.57 / $50.94 / $82.93	Professional	26	$33.57	$50.94	$82.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.39 / $114.04 / $187.47	Professional	TC	$76.39	$114.04	$187.47
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $43.97 / $43.97 / $47.86	Facility	26	$43.97	$43.97	$47.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $110.82 / $159.13 / $269.47	Professional		$110.82	$159.13	$269.47
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $37.31 / $54.34 / $101.70	Professional	26	$37.31	$54.34	$101.70
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $77.58 / $112.09 / $185.65	Professional	TC	$77.58	$112.09	$185.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.51 / $117.26 / $181.19	Professional		$40.51	$117.26	$181.19
United Facility/Professional Professional Modifier Low / Median / High Price $116.62 / $150.19 / $259.20	Professional		$116.62	$150.19	$259.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.81 / $47.31 / $82.76	Professional	26	$35.81	$47.31	$82.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.84 / $103.80 / $179.66	Professional	TC	$79.84	$103.80	$179.66