Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.03 / $69.41 / $197.55	Professional		$67.03	$69.41	$197.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $48.03 / $180.76	Professional	26	$46.09	$48.03	$180.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.44 / $23.32 / $66.66	Professional	TC	$19.44	$23.32	$66.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $42.21 / $78.79	Professional	26	$28.14	$42.21	$78.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.67 / $103.33 / $190.69	Professional		$74.67	$103.33	$190.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.68 / $72.98 / $134.71	Professional	26	$55.68	$72.98	$134.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.97 / $28.67 / $52.47	Professional	TC	$19.97	$28.67	$52.47
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $64.69 / $64.69 / $67.63	Professional		$64.69	$64.69	$67.63
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $43.34 / $43.34 / $45.31	Professional	26	$43.34	$43.34	$45.31
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $21.36 / $21.36 / $22.33	Professional	TC	$21.36	$21.36	$22.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $66.58 / $130.49	Professional		$27.89	$66.58	$130.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.01 / $84.02 / $152.65	Professional		$42.01	$84.02	$152.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $56.28 / $104.51	Professional	26	$28.14	$56.28	$104.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.36 / $27.58 / $49.56	Professional	TC	$13.36	$27.58	$49.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $42.01 / $84.02 / $141.19	Professional		$42.01	$84.02	$141.19
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $61.74 / $127.27	Professional	26	$28.14	$61.74	$127.27
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $13.36 / $27.74 / $55.48	Professional	TC	$13.36	$27.74	$55.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $69.51 / $128.85	Professional		$30.24	$69.51	$128.85
United Facility/Professional Professional Modifier Low / Median / High Price $52.82 / $88.03 / $149.65	Professional		$52.82	$88.03	$149.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.26 / $63.07 / $108.05	Professional	26	$35.26	$63.07	$108.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.69 / $24.48 / $43.74	Professional	TC	$14.69	$24.48	$43.74