Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $128.82 / $186.21	Facility	26	$97.72	$128.82	$186.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $478.63 / $977.24	Professional		$363.08	$478.63	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $147.91 / $354.81	Professional	26	$95.50	$147.91	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $363.08 / $794.33	Professional	TC	$263.03	$363.08	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $467.74	Professional		$309.03	$309.03	$467.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $102.33 / $186.21	Professional	26	$85.11	$102.33	$186.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $501.19 / $741.31	Professional		$398.11	$501.19	$741.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $123.03 / $181.97	Professional	26	$97.72	$123.03	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $380.19 / $562.34	Professional	TC	$302.00	$380.19	$562.34
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $524.81 / $676.08	Professional		$426.58	$524.81	$676.08
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $141.25 / $186.21	Professional	26	$117.49	$141.25	$186.21
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $380.19 / $501.19	Professional	TC	$309.03	$380.19	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $512.86 / $912.01	Professional		$371.54	$512.86	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $138.04 / $239.88	Professional	26	$100.00	$138.04	$239.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $389.05 / $676.08	Professional	TC	$269.15	$389.05	$676.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $512.86 / $851.14	Professional		$371.54	$512.86	$851.14
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $134.90 / $223.87	Professional	26	$100.00	$134.90	$223.87
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $380.19 / $630.96	Professional	TC	$269.15	$380.19	$630.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $489.78 / $870.96	Professional		$389.05	$489.78	$870.96
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $131.83 / $234.42	Professional	26	$107.15	$131.83	$234.42
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $354.81 / $630.96	Professional	TC	$288.40	$354.81	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $467.74 / $794.33	Professional		$331.13	$467.74	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $117.49 / $194.98	Professional	26	$83.18	$117.49	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $354.81 / $602.56	Professional	TC	$245.47	$354.81	$602.56