Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $30.20 / $43.65	Facility	26	$22.39	$30.20	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $257.04 / $954.99	Professional		$194.98	$257.04	$954.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $35.48 / $83.18	Professional	26	$20.42	$35.48	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $229.09 / $512.86	Professional	TC	$173.78	$229.09	$512.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.98 / $19.50 / $40.74	Professional	26	$3.98	$19.50	$40.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $269.15 / $426.58	Professional		$218.78	$269.15	$426.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $28.84 / $45.71	Professional	26	$23.44	$28.84	$45.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $245.47 / $380.19	Professional	TC	$194.98	$245.47	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $562.34	Professional		$199.53	$302.00	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.90 / $57.54	Professional	26	$21.88	$30.90	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $269.15 / $501.19	Professional	TC	$177.83	$269.15	$501.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $302.00 / $524.81	Professional		$199.53	$302.00	$524.81
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.88 / $58.88	Professional	26	$21.88	$33.88	$58.88
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $269.15 / $467.74	Professional	TC	$186.21	$269.15	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $489.78 / $489.78 / $489.78	Facility	26	$489.78	$489.78	$489.78
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $446.68	Professional		$213.80	$309.03	$446.68
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $32.36 / $51.29	Professional	26	$24.55	$32.36	$51.29
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $269.15 / $398.11	Professional	TC	$190.55	$269.15	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $251.19 / $446.68	Professional		$190.55	$251.19	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.30 / $46.77	Professional	26	$19.05	$26.30	$46.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $229.09 / $398.11	Professional	TC	$158.49	$229.09	$398.11