Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.43 / $56.60 / $147.01	Facility	26	$40.43	$56.60	$147.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.19 / $436.79 / $774.20	Professional		$365.19	$436.79	$774.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.74 / $56.07 / $90.68	Professional	26	$37.74	$56.07	$90.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $324.76 / $399.06 / $688.49	Professional	TC	$324.76	$399.06	$688.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $55.41 / $69.27	Professional	26	$31.67	$55.41	$69.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.57 / $461.89 / $815.16	Professional		$354.57	$461.89	$815.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.51 / $47.53 / $77.95	Professional	26	$40.51	$47.53	$77.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $316.83 / $417.47 / $738.63	Professional	TC	$316.83	$417.47	$738.63
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $409.66 / $409.66 / $409.66	Professional		$409.66	$409.66	$409.66
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $46.70 / $46.70 / $46.70	Professional	26	$46.70	$46.70	$46.70
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $362.94 / $362.94 / $362.94	Professional	TC	$362.94	$362.94	$362.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.54 / $347.17 / $713.14	Professional		$43.54	$347.17	$713.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $379.53 / $577.61 / $1,060.36	Professional		$379.53	$577.61	$1,060.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.67 / $56.72 / $97.87	Professional	26	$40.67	$56.72	$97.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $338.34 / $519.97 / $948.88	Professional	TC	$338.34	$519.97	$948.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $351.89 / $534.25 / $951.42	Professional		$351.89	$534.25	$951.42
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $41.56 / $63.33 / $110.21	Professional	26	$41.56	$63.33	$110.21
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $338.34 / $487.29 / $948.88	Professional	TC	$338.34	$487.29	$948.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.71 / $392.13 / $574.55	Professional		$41.71	$392.13	$574.55
United Facility/Professional Professional Modifier Low / Median / High Price $345.78 / $470.82 / $892.05	Professional		$345.78	$470.82	$892.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.42 / $50.24 / $87.78	Professional	26	$35.42	$50.24	$87.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $296.95 / $425.87 / $781.71	Professional	TC	$296.95	$425.87	$781.71