Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.56 / $50.85 / $127.40	Facility	26	$35.56	$50.85	$127.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.87 / $305.11 / $588.28	Professional		$251.87	$305.11	$588.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.15 / $50.77 / $127.40	Professional	26	$35.15	$50.77	$127.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.71 / $268.31 / $512.89	Professional	TC	$218.71	$268.31	$512.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $303.95 / $303.95 / $303.95	Professional		$303.95	$303.95	$303.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.88 / $48.79 / $60.99	Professional	26	$27.88	$48.79	$60.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $193.00 / $241.34 / $398.02	Professional		$193.00	$241.34	$398.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.47 / $45.30 / $71.17	Professional	26	$38.47	$45.30	$71.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.52 / $194.20 / $329.99	Professional	TC	$154.52	$194.20	$329.99
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $311.87 / $311.87 / $311.87	Professional		$311.87	$311.87	$311.87
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $41.12 / $41.12 / $41.12	Professional	26	$41.12	$41.12	$41.12
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $270.76 / $270.76 / $270.76	Professional	TC	$270.76	$270.76	$270.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.34 / $264.30 / $532.02	Professional		$38.34	$264.30	$532.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.58 / $369.10 / $675.56	Professional		$245.58	$369.10	$675.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.20 / $50.13 / $85.99	Professional	26	$35.20	$50.13	$85.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.04 / $316.33 / $596.09	Professional	TC	$209.04	$316.33	$596.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $248.85 / $354.46 / $613.15	Professional		$248.85	$354.46	$613.15
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $35.20 / $52.98 / $101.12	Professional	26	$35.20	$52.98	$101.12
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $227.97 / $312.32 / $585.54	Professional	TC	$227.97	$312.32	$585.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $299.85 / $441.66	Professional		$42.05	$299.85	$441.66
United Facility/Professional Professional Modifier Low / Median / High Price $192.53 / $343.57 / $652.78	Professional		$192.53	$343.57	$652.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.33 / $43.87 / $75.43	Professional	26	$31.33	$43.87	$75.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.49 / $295.08 / $577.35	Professional	TC	$163.49	$295.08	$577.35