Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.23 / $82.79 / $163.66	Facility	26	$46.23	$82.79	$163.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.28 / $112.58 / $227.07	Professional		$85.28	$112.58	$227.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.42 / $56.82 / $115.52	Professional	26	$43.42	$56.82	$115.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.04 / $57.02 / $124.37	Professional	TC	$39.04	$57.02	$124.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.79 / $62.79 / $62.79	Professional		$62.79	$62.79	$62.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $48.34 / $48.34	Professional	26	$39.97	$48.34	$48.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.26 / $138.04 / $221.50	Professional		$105.26	$138.04	$221.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.93 / $59.52 / $87.07	Professional	26	$47.93	$59.52	$87.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.92 / $72.52 / $137.78	Professional	TC	$49.92	$72.52	$137.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.80 / $52.13 / $95.93	Professional		$43.80	$52.13	$95.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.33 / $78.33 / $78.33	Facility	26	$78.33	$78.33	$78.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.12 / $136.04 / $252.71	Professional		$87.12	$136.04	$252.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.26 / $64.97 / $114.47	Professional	26	$47.26	$64.97	$114.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.65 / $62.46 / $135.96	Professional	TC	$39.65	$62.46	$135.96
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $78.33 / $78.33 / $78.33	Facility	26	$78.33	$78.33	$78.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.12 / $135.18 / $268.57	Professional		$87.12	$135.18	$268.57
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $48.49 / $65.91 / $126.94	Professional	26	$48.49	$65.91	$126.94
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $39.82 / $55.75 / $114.01	Professional	TC	$39.82	$55.75	$114.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.80 / $76.93 / $129.38	Professional		$32.80	$76.93	$129.38
United Facility/Professional Professional Modifier Low / Median / High Price $85.46 / $111.23 / $213.77	Professional		$85.46	$111.23	$213.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.74 / $55.75 / $99.43	Professional	26	$37.74	$55.75	$99.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.81 / $51.05 / $115.93	Professional	TC	$37.81	$51.05	$115.93