Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.17 / $43.80 / $67.00	Facility	26	$26.17	$43.80	$67.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.64 / $122.82 / $493.07	Professional		$100.64	$122.82	$493.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.24 / $35.33 / $112.00	Professional	26	$24.24	$35.33	$112.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.48 / $87.08 / $149.19	Professional	TC	$74.48	$87.08	$149.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.82 / $122.82 / $122.82	Professional		$122.82	$122.82	$122.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $24.56 / $32.36	Professional	26	$18.48	$24.56	$32.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.99 / $120.99 / $219.32	Professional		$92.99	$120.99	$219.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.85 / $32.74 / $58.34	Professional	26	$24.85	$32.74	$58.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.39 / $83.99 / $152.60	Professional	TC	$65.39	$83.99	$152.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $25.43 / $80.80 / $122.82	Professional		$25.43	$80.80	$122.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.25 / $134.50 / $213.08	Professional		$93.25	$134.50	$213.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.05 / $35.31 / $52.46	Professional	26	$25.05	$35.31	$52.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $99.95 / $162.47	Professional	TC	$68.95	$99.95	$162.47
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $87.73 / $128.09 / $202.20	Professional		$87.73	$128.09	$202.20
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $25.05 / $35.34 / $53.17	Professional	26	$25.05	$35.34	$53.17
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $67.84 / $99.56 / $151.08	Professional	TC	$67.84	$99.56	$151.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $79.73 / $131.17	Professional		$40.43	$79.73	$131.17
United Facility/Professional Professional Modifier Low / Median / High Price $87.60 / $123.51 / $203.49	Professional		$87.60	$123.51	$203.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.70 / $30.92 / $52.41	Professional	26	$22.70	$30.92	$52.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.83 / $92.56 / $138.91	Professional	TC	$64.83	$92.56	$138.91