Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $67.09 / $172.13	Professional		$46.00	$67.09	$172.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.84 / $25.12 / $56.75	Professional	26	$16.84	$25.12	$56.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.29 / $42.77 / $101.92	Professional	TC	$30.29	$42.77	$101.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $20.66 / $28.64	Professional	26	$10.23	$20.66	$28.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.32 / $36.53 / $99.71	Professional		$28.32	$36.53	$99.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $12.35 / $46.07	Professional	26	$9.50	$12.35	$46.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $25.05 / $65.38	Professional	TC	$19.73	$25.05	$65.38
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $48.69 / $48.69 / $50.90	Professional		$48.69	$48.69	$50.90
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $22.51 / $22.51 / $23.53	Professional	26	$22.51	$22.51	$23.53
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $32.93 / $32.93 / $34.43	Professional	TC	$32.93	$32.93	$34.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.53 / $51.32 / $85.67	Facility		$20.53	$51.32	$85.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.46 / $51.32 / $99.16	Professional		$20.46	$51.32	$99.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $94.22 / $94.22 / $94.22	Facility		$94.22	$94.22	$94.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.61 / $60.82 / $105.34	Professional		$31.61	$60.82	$105.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $21.48 / $41.88	Professional	26	$10.23	$21.48	$41.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.95 / $34.54 / $70.56	Professional	TC	$18.95	$34.54	$70.56
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $94.22 / $94.22 / $94.22	Facility		$94.22	$94.22	$94.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $31.61 / $61.04 / $116.83	Professional		$31.61	$61.04	$116.83
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $22.55 / $54.12	Professional	26	$10.23	$22.55	$54.12
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $18.95 / $34.54 / $74.95	Professional	TC	$18.95	$34.54	$74.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.88 / $50.69 / $95.42	Professional		$27.88	$50.69	$95.42
United Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $59.23 / $107.86	Professional		$35.54	$59.23	$107.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.72 / $22.86 / $36.85	Professional	26	$13.72	$22.86	$36.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.82 / $36.36 / $66.23	Professional	TC	$21.82	$36.36	$66.23