Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.29 / $107.18 / $188.52	Facility	26	$63.29	$107.18	$188.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.18 / $114.36 / $258.99	Professional		$93.18	$114.36	$258.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.28 / $68.94 / $124.71	Professional	26	$57.28	$68.94	$124.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.02 / $45.74 / $77.75	Professional	TC	$30.02	$45.74	$77.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.09 / $114.88 / $148.38	Professional		$110.09	$114.88	$148.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.27 / $73.06 / $84.32	Professional	26	$52.27	$73.06	$84.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.72 / $117.24 / $206.96	Professional		$93.72	$117.24	$206.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.17 / $81.73 / $137.66	Professional	26	$63.17	$81.73	$137.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.65 / $36.77 / $66.41	Professional	TC	$27.65	$36.77	$66.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $43.68 / $83.73 / $143.25	Professional		$43.68	$83.73	$143.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.20 / $68.20 / $68.20	Facility	26	$68.20	$68.20	$68.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.01 / $129.24 / $206.08	Professional		$94.01	$129.24	$206.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.02 / $82.25 / $142.44	Professional	26	$59.02	$82.25	$142.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.79 / $47.43 / $82.23	Professional	TC	$29.79	$47.43	$82.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.23 / $127.14 / $194.27	Professional		$89.23	$127.14	$194.27
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $59.02 / $81.50 / $129.28	Professional	26	$59.02	$81.50	$129.28
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $28.72 / $47.43 / $77.12	Professional	TC	$28.72	$47.43	$77.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.88 / $47.95 / $124.14	Professional		$27.88	$47.95	$124.14
United Facility/Professional Professional Modifier Low / Median / High Price $80.27 / $119.29 / $199.56	Professional		$80.27	$119.29	$199.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.90 / $75.66 / $130.16	Professional	26	$52.90	$75.66	$130.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.52 / $39.00 / $68.77	Professional	TC	$25.52	$39.00	$68.77