Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $57.54 / $141.25	Facility	26	$47.86	$57.54	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $338.84 / $812.83	Professional		$269.15	$338.84	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $72.44 / $173.78	Professional	26	$44.67	$72.44	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $288.40 / $676.08	Professional	TC	$229.09	$288.40	$676.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $46.77 / $87.10	Professional	26	$39.81	$46.77	$87.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $380.19 / $616.60	Professional		$309.03	$380.19	$616.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $61.66 / $95.50	Professional	26	$48.98	$61.66	$95.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $323.59 / $512.86	Professional	TC	$257.04	$323.59	$512.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $389.05 / $794.33	Professional		$269.15	$389.05	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $66.07 / $123.03	Professional	26	$46.77	$66.07	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $346.74 / $676.08	Professional	TC	$229.09	$346.74	$676.08
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $416.87 / $794.33	Professional		$281.84	$416.87	$794.33
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $70.79 / $131.83	Professional	26	$48.98	$70.79	$131.83
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $346.74 / $676.08	Professional	TC	$229.09	$346.74	$676.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	26	$660.69	$660.69	$660.69
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $416.87 / $616.60	Professional		$295.12	$416.87	$616.60
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $109.65	Professional	26	$52.48	$69.18	$109.65
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $346.74 / $512.86	Professional	TC	$245.47	$346.74	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $346.74 / $616.60	Professional		$257.04	$346.74	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $102.33	Professional	26	$40.74	$56.23	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $288.40 / $512.86	Professional	TC	$213.80	$288.40	$512.86