Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.40 / $36.32 / $89.08	Facility	26	$25.40	$36.32	$89.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.24 / $96.41 / $177.01	Professional		$82.24	$96.41	$177.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $25.71 / $73.34	Professional	26	$22.87	$25.71	$73.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.84 / $70.18 / $132.18	Professional	TC	$58.84	$70.18	$132.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.78 / $73.78 / $185.02	Professional		$73.78	$73.78	$185.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.38 / $30.49 / $40.92	Professional	26	$19.38	$30.49	$40.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $94.87 / $160.09	Professional		$67.00	$94.87	$160.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $32.04 / $56.81	Professional	26	$24.87	$32.04	$56.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.00 / $60.46 / $107.94	Professional	TC	$40.00	$60.46	$107.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $71.06 / $98.23	Professional		$27.16	$71.06	$98.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $31.83	Facility	26	$30.07	$30.07	$31.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $120.70 / $215.41	Professional		$81.79	$120.70	$215.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.96 / $34.79 / $57.99	Professional	26	$22.96	$34.79	$57.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.96 / $87.32 / $154.76	Professional	TC	$57.96	$87.32	$154.76
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $31.83	Facility	26	$30.07	$30.07	$31.83
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $82.19 / $124.13 / $203.65	Professional		$82.19	$124.13	$203.65
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $25.05 / $36.29 / $69.12	Professional	26	$25.05	$36.29	$69.12
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $61.13 / $90.10 / $150.87	Professional	TC	$61.13	$90.10	$150.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.46 / $82.38 / $132.19	Professional		$40.46	$82.38	$132.19
United Facility/Professional Professional Modifier Low / Median / High Price $76.04 / $105.66 / $183.77	Professional		$76.04	$105.66	$183.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.78 / $31.38 / $54.61	Professional	26	$22.78	$31.38	$54.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.46 / $73.67 / $127.99	Professional	TC	$54.46	$73.67	$127.99