Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.95 / $42.45 / $75.29	Facility	26	$22.95	$42.45	$75.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.22 / $154.22 / $295.36	Professional		$115.22	$154.22	$295.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $23.84 / $51.54	Professional	26	$18.76	$23.84	$51.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.27 / $113.82 / $204.06	Professional	TC	$92.27	$113.82	$204.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.41 / $84.41 / $84.41	Professional		$84.41	$84.41	$84.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.91 / $18.84 / $35.21	Professional	26	$16.91	$18.84	$35.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.80 / $160.57 / $299.11	Professional		$128.80	$160.57	$299.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.01 / $24.79 / $41.74	Professional	26	$18.01	$24.79	$41.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $105.51 / $136.24 / $255.72	Professional	TC	$105.51	$136.24	$255.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.17 / $97.01 / $135.37	Professional		$24.17	$97.01	$135.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.66 / $165.84 / $286.49	Professional		$115.66	$165.84	$286.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.70 / $29.72 / $47.01	Professional	26	$21.70	$29.72	$47.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.60 / $136.69 / $246.92	Professional	TC	$92.60	$136.69	$246.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $114.19 / $161.31 / $260.55	Professional		$114.19	$161.31	$260.55
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $21.97 / $29.80 / $45.98	Professional	26	$21.97	$29.80	$45.98
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $92.60 / $133.93 / $233.75	Professional	TC	$92.60	$133.93	$233.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $115.47 / $179.83	Professional		$40.43	$115.47	$179.83
United Facility/Professional Professional Modifier Low / Median / High Price $109.88 / $160.32 / $279.00	Professional		$109.88	$160.32	$279.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $29.66 / $55.05	Professional	26	$19.73	$29.66	$55.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.80 / $135.37 / $231.79	Professional	TC	$88.80	$135.37	$231.79