Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $51.92 / $129.07	Facility	26	$36.31	$51.92	$129.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.52 / $121.94 / $231.60	Professional		$52.52	$121.94	$231.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $39.22 / $67.16	Professional	26	$36.31	$39.22	$67.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.03 / $85.63 / $168.34	Professional	TC	$16.03	$85.63	$168.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.92 / $48.93 / $48.93	Professional	26	$34.92	$48.93	$48.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.65 / $87.25 / $155.68	Professional		$68.65	$87.25	$155.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.03 / $50.65 / $76.52	Professional	26	$42.03	$50.65	$76.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.25 / $33.00 / $111.52	Professional	TC	$22.25	$33.00	$111.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $92.01 / $135.77	Professional		$41.40	$92.01	$135.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.82 / $61.82 / $61.82	Facility	26	$61.82	$61.82	$61.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.73 / $141.94 / $289.27	Professional		$80.73	$141.94	$289.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.64 / $52.69 / $90.72	Professional	26	$37.64	$52.69	$90.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.95 / $94.37 / $191.42	Professional	TC	$17.95	$94.37	$191.42
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $61.82 / $61.82 / $61.82	Facility	26	$61.82	$61.82	$61.82
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $77.33 / $141.94 / $259.20	Professional		$77.33	$141.94	$259.20
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $37.77 / $52.69 / $84.31	Professional	26	$37.77	$52.69	$84.31
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $17.29 / $98.11 / $180.16	Professional	TC	$17.29	$98.11	$180.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.02 / $122.72 / $185.09	Professional		$41.02	$122.72	$185.09
United Facility/Professional Professional Modifier Low / Median / High Price $61.55 / $122.35 / $233.83	Professional		$61.55	$122.35	$233.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.42 / $46.52 / $77.48	Professional	26	$33.42	$46.52	$77.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.00 / $80.09 / $147.37	Professional	TC	$20.00	$80.09	$147.37