Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.12 / $43.07 / $107.19	Facility	26	$30.12	$43.07	$107.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.56 / $102.14 / $533.91	Professional		$59.56	$102.14	$533.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.12 / $70.70 / $424.98	Professional	26	$30.12	$70.70	$424.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.44 / $44.02 / $104.17	Professional	TC	$29.44	$44.02	$104.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.26 / $49.17 / $68.64	Professional		$44.26	$49.17	$68.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.86 / $31.70 / $48.17	Professional	26	$24.86	$31.70	$48.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.06 / $82.48 / $127.67	Professional		$69.06	$82.48	$127.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.84 / $38.85 / $57.37	Professional	26	$30.84	$38.85	$57.37
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.65 / $42.60 / $76.26	Professional	TC	$35.65	$42.60	$76.26
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $72.53 / $72.53 / $112.49	Professional		$72.53	$72.53	$112.49
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $36.67 / $36.67 / $56.88	Professional	26	$36.67	$36.67	$56.88
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $35.86 / $35.86 / $55.61	Professional	TC	$35.86	$35.86	$55.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $31.08 / $41.96 / $82.98	Professional		$31.08	$41.96	$82.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.21 / $51.21 / $51.21	Facility	26	$51.21	$51.21	$51.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.92 / $87.61 / $150.24	Professional		$60.92	$87.61	$150.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.73 / $42.50 / $74.65	Professional	26	$30.73	$42.50	$74.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.85 / $47.10 / $81.52	Professional	TC	$29.85	$47.10	$81.52
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $51.21 / $51.21 / $51.21	Facility	26	$51.21	$51.21	$51.21
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $60.92 / $89.81 / $179.14	Professional		$60.92	$89.81	$179.14
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $31.08 / $43.64 / $84.94	Professional	26	$31.08	$43.64	$84.94
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $29.85 / $42.55 / $78.84	Professional	TC	$29.85	$42.55	$78.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $49.35 / $90.23	Professional		$31.17	$49.35	$90.23
United Facility/Professional Professional Modifier Low / Median / High Price $55.14 / $75.59 / $134.41	Professional		$55.14	$75.59	$134.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.84 / $38.75 / $63.98	Professional	26	$25.84	$38.75	$63.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.85 / $37.70 / $65.15	Professional	TC	$29.85	$37.70	$65.15