Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.20 / $54.75 / $148.75	Facility	26	$32.20	$54.75	$148.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.00 / $155.62 / $371.86	Professional		$124.00	$155.62	$371.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $48.52 / $102.85	Professional	26	$32.20	$48.52	$102.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.97 / $99.05 / $273.37	Professional	TC	$90.97	$99.05	$273.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $29.34 / $54.76	Professional	26	$19.55	$29.34	$54.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.44 / $90.03 / $270.57	Professional		$73.44	$90.03	$270.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.60 / $29.38 / $72.93	Professional	26	$22.60	$29.38	$72.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.63 / $65.83 / $159.97	Professional	TC	$46.63	$65.83	$159.97
Aultcare Facility/Professional Facility Modifier 26 Low / Median / High Price $24.64 / $24.64 / $24.64	Facility	26	$24.64	$24.64	$24.64
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $125.96 / $125.96 / $125.96	Professional		$125.96	$125.96	$125.96
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.49 / $31.49 / $31.49	Professional	26	$31.49	$31.49	$31.49
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $94.47 / $94.47 / $94.47	Professional	TC	$94.47	$94.47	$94.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.01 / $152.57 / $257.70	Professional		$41.01	$152.57	$257.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.23 / $115.16 / $254.78	Professional		$78.23	$115.16	$254.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $39.78 / $73.33	Professional	26	$19.55	$39.78	$73.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.10 / $72.13 / $187.78	Professional	TC	$54.10	$72.13	$187.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $78.23 / $114.03 / $250.36	Professional		$78.23	$114.03	$250.36
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $44.98 / $106.01	Professional	26	$19.55	$44.98	$106.01
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $54.10 / $72.13 / $203.61	Professional	TC	$54.10	$72.13	$203.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.90 / $158.26 / $241.89	Professional		$40.90	$158.26	$241.89
United Facility/Professional Professional Modifier Low / Median / High Price $88.09 / $171.31 / $266.89	Professional		$88.09	$171.31	$266.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.84 / $44.73 / $67.77	Professional	26	$26.84	$44.73	$67.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.35 / $106.87 / $179.70	Professional	TC	$54.35	$106.87	$179.70