Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $28.84 / $44.67	Facility	26	$7.59	$28.84	$44.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $23.99 / $75.86	Professional	26	$5.75	$23.99	$75.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $134.90	Professional	TC	$18.20	$25.70	$134.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $25.70 / $37.15	Professional	26	$19.50	$25.70	$37.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $26.30 / $40.74	Professional	26	$10.47	$26.30	$40.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $79.43 / $125.89	Professional	TC	$13.49	$79.43	$125.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.88 / $60.26	Professional	26	$23.99	$33.88	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $102.33 / $181.97	Professional	TC	$70.79	$102.33	$181.97
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.11 / $60.26	Professional	26	$23.99	$33.11	$60.26
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $97.72 / $154.88	Professional	TC	$70.79	$97.72	$154.88
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 26 Low / Median / High Price $25.12 / $29.51 / $47.86	Professional	26	$25.12	$29.51	$47.86
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $87.10 / $120.23	Professional	TC	$61.66	$87.10	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $32.36 / $58.88	Professional	26	$24.55	$32.36	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $102.33 / $177.83	Professional	TC	$75.86	$102.33	$177.83