Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.71 / $49.64 / $122.08	Facility	26	$34.71	$49.64	$122.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.65 / $274.25 / $494.38	Professional		$191.65	$274.25	$494.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $48.50 / $89.51	Professional	26	$32.20	$48.50	$89.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.46 / $240.20 / $434.71	Professional	TC	$159.46	$240.20	$434.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $172.18 / $172.18 / $239.36	Professional		$172.18	$172.18	$239.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.35 / $36.14 / $53.36	Professional	26	$28.35	$36.14	$53.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.88 / $206.71 / $349.12	Professional		$158.88	$206.71	$349.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.40 / $44.78 / $72.50	Professional	26	$36.40	$44.78	$72.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.49 / $159.22 / $284.95	Professional	TC	$122.49	$159.22	$284.95
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $282.17 / $282.17 / $437.61	Professional		$282.17	$282.17	$437.61
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $41.81 / $41.81 / $64.84	Professional	26	$41.81	$41.81	$64.84
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $240.37 / $240.37 / $372.77	Professional	TC	$240.37	$240.37	$372.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.11 / $240.84 / $361.26	Professional		$42.11	$240.84	$361.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.42 / $58.42 / $58.42	Facility	26	$58.42	$58.42	$58.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.46 / $309.37 / $569.04	Professional		$220.46	$309.37	$569.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.43 / $48.36 / $84.00	Professional	26	$35.43	$48.36	$84.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.56 / $256.10 / $485.16	Professional	TC	$184.56	$256.10	$485.16
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $58.42 / $58.42 / $58.42	Facility	26	$58.42	$58.42	$58.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $184.81 / $298.92 / $569.04	Professional		$184.81	$298.92	$569.04
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $35.74 / $49.60 / $98.99	Professional	26	$35.74	$49.60	$98.99
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $196.69 / $256.10 / $427.77	Professional	TC	$196.69	$256.10	$427.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.02 / $262.48 / $386.45	Professional		$41.02	$262.48	$386.45
United Facility/Professional Professional Modifier Low / Median / High Price $157.60 / $278.04 / $511.61	Professional		$157.60	$278.04	$511.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.75 / $41.35 / $73.38	Professional	26	$26.75	$41.35	$73.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $130.38 / $238.04 / $432.57	Professional	TC	$130.38	$238.04	$432.57