Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.87 / $79.89 / $198.24	Facility	26	$55.87	$79.89	$198.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.26 / $194.71 / $738.38	Professional		$113.26	$194.71	$738.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.87 / $98.36 / $619.29	Professional	26	$55.87	$98.36	$619.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.39 / $98.42 / $199.92	Professional	TC	$57.39	$98.42	$199.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.15 / $83.15 / $129.02	Professional		$83.15	$83.15	$129.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.68 / $65.98 / $79.94	Professional	26	$45.68	$65.98	$79.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.47 / $177.13 / $308.81	Professional		$135.47	$177.13	$308.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.88 / $75.84 / $130.10	Professional	26	$63.88	$75.84	$130.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $73.54 / $97.50 / $182.52	Professional	TC	$73.54	$97.50	$182.52
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $136.28 / $136.28 / $136.28	Professional		$136.28	$136.28	$136.28
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $67.38 / $67.38 / $67.38	Professional	26	$67.38	$67.38	$67.38
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $68.90 / $68.90 / $68.90	Professional	TC	$68.90	$68.90	$68.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.39 / $78.83 / $155.91	Professional		$58.39	$78.83	$155.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.84 / $94.84 / $94.84	Facility	26	$94.84	$94.84	$94.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.88 / $179.00 / $316.44	Professional		$116.88	$179.00	$316.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.10 / $79.59 / $138.21	Professional	26	$57.10	$79.59	$138.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.71 / $97.02 / $176.48	Professional	TC	$58.71	$97.02	$176.48
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $94.84 / $94.84 / $94.84	Facility	26	$94.84	$94.84	$94.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $116.88 / $184.78 / $328.32	Professional		$116.88	$184.78	$328.32
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $58.17 / $80.26 / $141.81	Professional	26	$58.17	$80.26	$141.81
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $59.55 / $90.50 / $160.02	Professional	TC	$59.55	$90.50	$160.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.34 / $90.02 / $171.92	Professional		$61.34	$90.02	$171.92
United Facility/Professional Professional Modifier Low / Median / High Price $114.63 / $149.82 / $247.53	Professional		$114.63	$149.82	$247.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.14 / $70.48 / $119.32	Professional	26	$49.14	$70.48	$119.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.79 / $78.83 / $132.38	Professional	TC	$59.79	$78.83	$132.38