Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.64 / $65.90 / $177.94	Professional		$52.64	$65.90	$177.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.02 / $37.00 / $86.35	Professional	26	$29.02	$37.00	$86.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.75 / $25.09 / $38.32	Professional	TC	$19.75	$25.09	$38.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.26 / $58.35 / $75.84	Professional		$54.26	$58.35	$75.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $34.15 / $34.15	Professional	26	$34.15	$34.15	$34.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.46 / $62.08 / $106.11	Professional		$43.46	$62.08	$106.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.84 / $35.79 / $58.58	Professional	26	$27.84	$35.79	$58.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $26.62 / $49.22	Professional	TC	$14.45	$26.62	$49.22
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $58.35 / $58.35 / $58.35	Professional		$58.35	$58.35	$58.35
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $34.15 / $34.15	Professional	26	$34.15	$34.15	$34.15
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $24.20 / $24.20 / $24.20	Professional	TC	$24.20	$24.20	$24.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.20 / $40.98 / $75.86	Professional		$24.20	$40.98	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.12 / $69.03 / $115.22	Professional		$47.12	$69.03	$115.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.69 / $40.97 / $70.19	Professional	26	$28.69	$40.97	$70.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.34 / $27.83 / $45.49	Professional	TC	$18.34	$27.83	$45.49
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $48.44 / $70.02 / $116.21	Professional		$48.44	$70.02	$116.21
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $29.02 / $41.12 / $73.91	Professional	26	$29.02	$41.12	$73.91
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $18.70 / $27.83 / $46.98	Professional	TC	$18.70	$27.83	$46.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.03 / $47.95 / $88.78	Professional		$28.03	$47.95	$88.78
United Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $54.91 / $92.35	Professional		$39.79	$54.91	$92.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.45 / $33.60 / $56.48	Professional	26	$26.45	$33.60	$56.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $22.06 / $35.90	Professional	TC	$14.45	$22.06	$35.90