Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.93 / $72.47 / $127.46	Facility	26	$42.93	$72.47	$127.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.54 / $85.93 / $285.32	Professional		$65.54	$85.93	$285.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $47.02 / $86.21	Professional	26	$40.11	$47.02	$86.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.28 / $39.07 / $66.41	Professional	TC	$23.28	$39.07	$66.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.81 / $86.22 / $154.00	Professional		$66.81	$86.22	$154.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $53.51 / $59.24	Professional	26	$49.69	$53.51	$59.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.89 / $83.16 / $146.99	Professional		$65.89	$83.16	$146.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.29 / $54.72 / $92.16	Professional	26	$42.29	$54.72	$92.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $29.21 / $52.15	Professional	TC	$21.32	$29.21	$52.15
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $93.41 / $93.41 / $93.41	Professional		$93.41	$93.41	$93.41
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $49.69 / $49.69	Professional	26	$49.69	$49.69	$49.69
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $43.72 / $43.72 / $43.72	Professional	TC	$43.72	$43.72	$43.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $62.27 / $107.49	Professional		$37.15	$62.27	$107.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.26 / $46.26 / $46.26	Facility	26	$46.26	$46.26	$46.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.53 / $93.41 / $154.62	Professional		$66.53	$93.41	$154.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.13 / $55.74 / $95.28	Professional	26	$40.13	$55.74	$95.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.18 / $38.68 / $70.94	Professional	TC	$24.18	$38.68	$70.94
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $62.94 / $93.08 / $143.71	Professional		$62.94	$93.08	$143.71
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $39.83 / $55.52 / $87.91	Professional	26	$39.83	$55.52	$87.91
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $24.18 / $38.47 / $66.52	Professional	TC	$24.18	$38.47	$66.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.96 / $46.80 / $84.70	Professional		$27.96	$46.80	$84.70
United Facility/Professional Professional Modifier Low / Median / High Price $57.80 / $83.43 / $151.63	Professional		$57.80	$83.43	$151.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.29 / $51.16 / $88.62	Professional	26	$35.29	$51.16	$88.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.75 / $32.06 / $60.34	Professional	TC	$20.75	$32.06	$60.34