Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.63 / $31.19 / $54.87	Facility	26	$18.63	$31.19	$54.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.03 / $68.20 / $238.80	Professional		$52.03	$68.20	$238.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.51 / $23.56 / $77.09	Professional	26	$17.51	$23.56	$77.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.40 / $45.64 / $98.69	Professional	TC	$33.40	$45.64	$98.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.52 / $63.52 / $63.52	Professional		$63.52	$63.52	$63.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.17 / $16.79 / $25.51	Professional	26	$13.17	$16.79	$25.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.89 / $84.37 / $144.00	Professional		$58.89	$84.37	$144.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.60 / $25.77 / $43.30	Professional	26	$17.60	$25.77	$43.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.53 / $62.21 / $105.11	Professional	TC	$37.53	$62.21	$105.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $18.11 / $37.60 / $63.52	Professional		$18.11	$37.60	$63.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.79 / $75.36 / $132.27	Professional		$49.79	$75.36	$132.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $25.23 / $37.43	Professional	26	$17.82	$25.23	$37.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.81 / $49.38 / $90.72	Professional	TC	$31.81	$49.38	$90.72
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $47.64 / $72.62 / $127.14	Professional		$47.64	$72.62	$127.14
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $25.23 / $37.13	Professional	26	$17.82	$25.23	$37.13
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $31.81 / $47.28 / $83.28	Professional	TC	$31.81	$47.28	$83.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $35.58 / $50.20	Professional		$25.98	$35.58	$50.20
United Facility/Professional Professional Modifier Low / Median / High Price $48.86 / $74.88 / $124.09	Professional		$48.86	$74.88	$124.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $22.07 / $37.42	Professional	26	$15.96	$22.07	$37.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.37 / $44.62 / $80.75	Professional	TC	$30.37	$44.62	$80.75