Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.62 / $88.13 / $185.07	Professional		$80.62	$88.13	$185.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.81 / $68.68 / $203.15	Professional	26	$65.81	$68.68	$203.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $21.62 / $67.75	Professional	TC	$19.32	$21.62	$67.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $113.92 / $113.92 / $113.92	Professional	26	$113.92	$113.92	$113.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.87 / $70.39 / $176.09	Professional		$54.87	$70.39	$176.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.58 / $47.55 / $134.44	Professional	26	$36.58	$47.55	$134.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.33 / $27.91 / $63.00	Professional	TC	$22.33	$27.91	$63.00
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $86.88 / $86.88 / $86.88	Professional		$86.88	$86.88	$86.88
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $65.50 / $65.50 / $65.50	Professional	26	$65.50	$65.50	$65.50
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $21.38 / $21.38	Professional	TC	$21.38	$21.38	$21.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.97 / $109.32 / $210.03	Professional		$53.97	$109.32	$210.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.69 / $81.37 / $145.51	Professional	26	$40.69	$81.37	$145.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.28 / $28.84 / $63.12	Professional	TC	$13.28	$28.84	$63.12
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $53.97 / $109.32 / $210.03	Professional		$53.97	$109.32	$210.03
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $40.69 / $85.44 / $163.10	Professional	26	$40.69	$85.44	$163.10
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $13.28 / $29.22 / $63.12	Professional	TC	$13.28	$29.22	$63.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.20 / $103.96 / $174.59	Professional		$31.20	$103.96	$174.59
United Facility/Professional Professional Modifier Low / Median / High Price $68.05 / $113.41 / $192.80	Professional		$68.05	$113.41	$192.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.56 / $88.93 / $151.19	Professional	26	$50.56	$88.93	$151.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.94 / $25.21 / $53.26	Professional	TC	$15.94	$25.21	$53.26