Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $77.62 / $158.49	Professional		$61.66	$77.62	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $69.18 / $398.11	Professional	26	$45.71	$69.18	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.70 / $50.12	Professional	TC	$20.89	$25.70	$50.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $28.18 / $28.18	Professional	26	$28.18	$28.18	$28.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $97.72 / $194.98	Professional		$75.86	$97.72	$194.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $69.18 / $134.90	Professional	26	$56.23	$69.18	$134.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $28.18 / $53.70	Professional	TC	$21.38	$28.18	$53.70
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $67.61 / $169.82	Professional		$64.57	$67.61	$169.82
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $45.71 / $112.20	Professional	26	$43.65	$45.71	$112.20
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $22.39 / $56.23	Professional	TC	$21.38	$22.39	$56.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $67.61 / $134.90	Professional		$27.54	$67.61	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $89.13 / $169.82	Professional		$41.69	$89.13	$169.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $56.23 / $107.15	Professional	26	$28.18	$56.23	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $26.30 / $51.29	Professional	TC	$12.30	$26.30	$51.29
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $81.28 / $141.25	Professional		$41.69	$81.28	$141.25
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $61.66 / $154.88	Professional	26	$28.18	$61.66	$154.88
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $26.30 / $54.95	Professional	TC	$12.30	$26.30	$54.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $194.98	Professional		$89.13	$117.49	$194.98
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $77.62 / $128.82	Professional	26	$58.88	$77.62	$128.82
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $38.90 / $60.26	Professional	TC	$29.51	$38.90	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $87.10 / $138.04	Professional		$51.29	$87.10	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $60.26 / $95.50	Professional	26	$34.67	$60.26	$95.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $24.55 / $41.69	Professional	TC	$14.79	$24.55	$41.69