Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.47 / $44.87 / $78.94	Facility	26	$26.47	$44.87	$78.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.79 / $61.54 / $122.03	Professional		$43.79	$61.54	$122.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.91 / $27.60 / $53.27	Professional	26	$23.91	$27.60	$53.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.87 / $34.88 / $58.84	Professional	TC	$17.87	$34.88	$58.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.89 / $82.89 / $82.89	Professional		$82.89	$82.89	$82.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.75 / $21.75 / $32.72	Professional	26	$21.75	$21.75	$32.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.42 / $57.75 / $100.65	Professional		$43.42	$57.75	$100.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.45 / $34.22 / $57.64	Professional	26	$26.45	$34.22	$57.64
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.32 / $22.76 / $42.51	Professional	TC	$16.32	$22.76	$42.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.72 / $33.11 / $66.84	Professional		$25.72	$33.11	$66.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.51 / $28.51 / $28.51	Facility	26	$28.51	$28.51	$28.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $67.48 / $111.83	Professional		$46.76	$67.48	$111.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $34.35 / $59.59	Professional	26	$24.55	$34.35	$59.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $33.86 / $63.75	Professional	TC	$21.65	$33.86	$63.75
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $66.98 / $101.88	Professional		$44.14	$66.98	$101.88
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $24.30 / $33.90 / $53.18	Professional	26	$24.30	$33.90	$53.18
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $33.49 / $59.78	Professional	TC	$21.65	$33.49	$59.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.88 / $46.63 / $85.00	Professional		$27.88	$46.63	$85.00
United Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $58.66 / $109.72	Professional		$38.65	$58.66	$109.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $31.68 / $54.86	Professional	26	$22.02	$31.68	$54.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.42 / $28.17 / $54.02	Professional	TC	$16.42	$28.17	$54.02