Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.50 / $64.15 / $135.00	Facility	26	$45.50	$64.15	$135.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.94 / $151.71 / $286.17	Professional		$134.94	$151.71	$286.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.94 / $46.93 / $93.94	Professional	26	$42.94	$46.93	$93.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.78 / $106.59 / $173.76	Professional	TC	$89.78	$106.59	$173.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.64 / $105.64 / $105.64	Professional		$105.64	$105.64	$105.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.32 / $43.32 / $43.32	Professional	26	$43.32	$43.32	$43.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.72 / $197.79 / $342.09	Professional		$147.72	$197.79	$342.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.81 / $62.47 / $111.72	Professional	26	$42.81	$62.47	$111.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.20 / $138.01 / $236.28	Professional	TC	$94.20	$138.01	$236.28
CareSource Facility/Professional Professional Modifier Low / Median / High Price $44.54 / $89.87 / $145.58	Professional		$44.54	$89.87	$145.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.78 / $189.97 / $317.04	Professional		$130.78	$189.97	$317.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $61.38 / $91.41	Professional	26	$43.88	$61.38	$91.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.02 / $127.10 / $225.32	Professional	TC	$87.02	$127.10	$225.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $123.88 / $186.63 / $305.62	Professional		$123.88	$186.63	$305.62
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $61.48 / $90.33	Professional	26	$43.88	$61.48	$90.33
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $86.90 / $124.93 / $196.12	Professional	TC	$86.90	$124.93	$196.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.51 / $116.67 / $181.19	Professional		$40.51	$116.67	$181.19
United Facility/Professional Professional Modifier Low / Median / High Price $122.40 / $179.85 / $284.61	Professional		$122.40	$179.85	$284.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.01 / $56.11 / $92.29	Professional	26	$41.01	$56.11	$92.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.14 / $119.50 / $194.13	Professional	TC	$83.14	$119.50	$194.13