Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.82 / $98.49 / $194.60	Facility	26	$53.82	$98.49	$194.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.22 / $186.56 / $350.56	Professional		$162.22	$186.56	$350.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $70.93 / $201.24	Professional	26	$51.54	$70.93	$201.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.37 / $125.34 / $234.39	Professional	TC	$109.37	$125.34	$234.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.08 / $42.08 / $73.64	Professional	26	$42.08	$42.08	$73.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $182.99 / $208.98 / $358.07	Professional		$182.99	$208.98	$358.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.01 / $69.18 / $120.06	Professional	26	$60.01	$69.18	$120.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $118.56 / $139.37 / $246.56	Professional	TC	$118.56	$139.37	$246.56
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $187.77 / $187.77 / $187.77	Professional		$187.77	$187.77	$187.77
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $62.07 / $62.07 / $62.07	Professional	26	$62.07	$62.07	$62.07
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $125.72 / $125.72 / $125.72	Professional	TC	$125.72	$125.72	$125.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.86 / $117.19 / $201.53	Professional		$57.86	$117.19	$201.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.58 / $240.16 / $406.76	Professional		$157.58	$240.16	$406.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.49 / $74.17 / $130.06	Professional	26	$53.49	$74.17	$130.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.21 / $157.91 / $280.73	Professional	TC	$103.21	$157.91	$280.73
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $157.07 / $233.66 / $411.89	Professional		$157.07	$233.66	$411.89
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $53.49 / $81.84 / $156.13	Professional	26	$53.49	$81.84	$156.13
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $106.00 / $151.19 / $280.73	Professional	TC	$106.00	$151.19	$280.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $159.46 / $235.47	Professional		$42.05	$159.46	$235.47
United Facility/Professional Professional Modifier Low / Median / High Price $140.36 / $200.51 / $361.09	Professional		$140.36	$200.51	$361.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.40 / $63.49 / $118.20	Professional	26	$40.40	$63.49	$118.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.95 / $134.63 / $232.45	Professional	TC	$99.95	$134.63	$232.45