Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.51 / $61.07 / $149.86	Facility	26	$42.51	$61.07	$149.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.15 / $66.29 / $126.01	Professional		$58.15	$66.29	$126.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.32 / $46.72 / $90.12	Professional	26	$40.32	$46.72	$90.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.92 / $19.94 / $33.35	Professional	TC	$16.92	$19.94	$33.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.74 / $43.74 / $43.74	Professional		$43.74	$43.74	$43.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.49 / $46.35 / $61.07	Professional	26	$44.49	$46.35	$61.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.05 / $74.84 / $110.06	Professional		$61.05	$74.84	$110.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.44 / $54.52 / $79.88	Professional	26	$43.44	$54.52	$79.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $20.62 / $32.44	Professional	TC	$16.89	$20.62	$32.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.84 / $47.98 / $66.83	Professional		$18.84	$47.98	$66.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.64 / $71.64 / $71.64	Facility	26	$71.64	$71.64	$71.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.44 / $83.84 / $148.85	Professional		$60.44	$83.84	$148.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.40 / $59.78 / $104.84	Professional	26	$43.40	$59.78	$104.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.00 / $23.85 / $42.95	Professional	TC	$17.00	$23.85	$42.95
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $71.64 / $71.64 / $71.64	Facility	26	$71.64	$71.64	$71.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $60.44 / $83.58 / $136.09	Professional		$60.44	$83.58	$136.09
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $43.77 / $60.30 / $97.71	Professional	26	$43.77	$60.30	$97.71
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $16.67 / $23.85 / $39.08	Professional	TC	$16.67	$23.85	$39.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.20 / $49.35 / $90.23	Professional		$31.20	$49.35	$90.23
United Facility/Professional Professional Modifier Low / Median / High Price $53.33 / $69.98 / $122.89	Professional		$53.33	$69.98	$122.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.67 / $51.01 / $89.83	Professional	26	$38.67	$51.01	$89.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.08 / $20.57 / $34.71	Professional	TC	$14.08	$20.57	$34.71