Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.30 / $98.20 / $172.73	Facility	26	$58.30	$98.20	$172.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.62 / $105.15 / $246.91	Professional		$83.62	$105.15	$246.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.62 / $63.15 / $117.38	Professional	26	$52.62	$63.15	$117.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.33 / $42.74 / $73.29	Professional	TC	$26.33	$42.74	$73.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.09 / $94.88 / $189.00	Professional		$70.09	$94.88	$189.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.80 / $72.52 / $80.29	Professional	26	$51.80	$72.52	$80.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.18 / $102.95 / $179.80	Professional		$80.18	$102.95	$179.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.33 / $68.88 / $117.77	Professional	26	$55.33	$68.88	$117.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.54 / $33.19 / $58.80	Professional	TC	$24.54	$33.19	$58.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $77.20 / $132.57	Professional		$40.74	$77.20	$132.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.81 / $62.81 / $62.81	Facility	26	$62.81	$62.81	$62.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.89 / $117.79 / $189.75	Professional		$84.89	$117.79	$189.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.39 / $75.58 / $119.92	Professional	26	$54.39	$75.58	$119.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.57 / $43.64 / $77.09	Professional	TC	$26.57	$43.64	$77.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $79.80 / $117.04 / $177.34	Professional		$79.80	$117.04	$177.34
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $53.47 / $75.09 / $110.87	Professional	26	$53.47	$75.09	$110.87
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $26.43 / $43.63 / $72.30	Professional	TC	$26.43	$43.63	$72.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.96 / $47.95 / $124.20	Professional		$27.96	$47.95	$124.20
United Facility/Professional Professional Modifier Low / Median / High Price $72.25 / $103.21 / $190.21	Professional		$72.25	$103.21	$190.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.70 / $69.65 / $120.64	Professional	26	$47.70	$69.65	$120.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.90 / $34.81 / $63.71	Professional	TC	$22.90	$34.81	$63.71