Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $44.67 / $79.43	Facility	26	$25.70	$44.67	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $66.07 / $147.91	Professional		$43.65	$66.07	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.20 / $64.57	Professional	26	$22.91	$30.20	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $34.67 / $61.66	Professional	TC	$17.78	$34.67	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $102.33	Professional		$57.54	$57.54	$102.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $61.66 / $102.33	Professional		$45.71	$61.66	$102.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $36.31 / $61.66	Professional	26	$27.54	$36.31	$61.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $23.99 / $43.65	Professional	TC	$17.38	$23.99	$43.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $40.74	Facility	26	$6.03	$28.18	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $69.18 / $123.03	Professional		$47.86	$69.18	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $36.31 / $63.10	Professional	26	$24.55	$36.31	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $35.48 / $69.18	Professional	TC	$21.88	$35.48	$69.18
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $40.74	Facility	26	$6.03	$28.18	$40.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $67.61 / $112.20	Professional		$43.65	$67.61	$112.20
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $35.48 / $56.23	Professional	26	$24.55	$35.48	$56.23
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $66.07	Professional	TC	$21.88	$33.11	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $32.36 / $33.11	Professional		$24.55	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Facility	26	$45.71	$45.71	$45.71
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $69.18 / $114.82	Professional		$58.88	$69.18	$114.82
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.20 / $50.12	Professional	26	$25.70	$30.20	$50.12
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.90 / $63.10	Professional	TC	$26.92	$38.90	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $104.71	Professional		$39.81	$57.54	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.20 / $52.48	Professional	26	$21.88	$30.20	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $26.30 / $52.48	Professional	TC	$16.22	$26.30	$52.48