Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.37 / $106.06 / $174.60	Professional		$94.37	$106.06	$174.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.81 / $78.58 / $120.19	Professional	26	$69.81	$78.58	$120.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.69 / $28.89 / $45.65	Professional	TC	$19.69	$28.89	$45.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.97 / $96.97 / $135.76	Professional		$96.97	$96.97	$135.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $71.29 / $78.42 / $99.81	Professional	26	$71.29	$78.42	$99.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.53 / $94.86 / $168.34	Professional		$68.53	$94.86	$168.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.66 / $77.56 / $221.59	Professional	26	$53.66	$77.56	$221.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.31 / $21.22 / $58.37	Professional	TC	$14.31	$21.22	$58.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.68 / $92.68 / $128.36	Professional		$25.68	$92.68	$128.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.49 / $116.43 / $197.97	Professional		$89.49	$116.43	$197.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.55 / $89.11 / $155.61	Professional	26	$67.55	$89.11	$155.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.30 / $29.53 / $54.05	Professional	TC	$21.30	$29.53	$54.05
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.49 / $120.59 / $238.37	Professional		$89.49	$120.59	$238.37
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $67.55 / $89.11 / $184.32	Professional	26	$67.55	$89.11	$184.32
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $21.30 / $29.53 / $54.05	Professional	TC	$21.30	$29.53	$54.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.81 / $105.08 / $173.38	Professional		$30.81	$105.08	$173.38
United Facility/Professional Professional Modifier Low / Median / High Price $71.31 / $93.25 / $168.45	Professional		$71.31	$93.25	$168.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.41 / $72.95 / $135.10	Professional	26	$56.41	$72.95	$135.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.85 / $23.36 / $41.30	Professional	TC	$13.85	$23.36	$41.30