Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.74 / $39.28 / $78.06	Facility	26	$23.74	$39.28	$78.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.65 / $120.86 / $217.13	Professional		$101.65	$120.86	$217.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.52 / $27.73 / $46.76	Professional	26	$23.52	$27.73	$46.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.04 / $97.12 / $173.27	Professional	TC	$69.04	$97.12	$173.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.75 / $19.75 / $27.46	Professional	26	$19.75	$19.75	$27.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.30 / $113.30 / $195.78	Professional		$78.30	$113.30	$195.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $36.85 / $62.20	Professional	26	$27.23	$36.85	$62.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.05 / $74.59 / $141.66	Professional	TC	$51.05	$74.59	$141.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $36.85 / $122.29 / $159.13	Professional		$36.85	$122.29	$159.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.66 / $205.72 / $357.65	Professional		$144.66	$205.72	$357.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.61 / $40.19 / $58.59	Professional	26	$25.61	$40.19	$58.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.31 / $170.26 / $306.57	Professional	TC	$120.31	$170.26	$306.57
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $142.44 / $206.38 / $332.73	Professional		$142.44	$206.38	$332.73
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $41.85 / $60.06	Professional	26	$25.75	$41.85	$60.06
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $120.86 / $172.32 / $288.95	Professional	TC	$120.86	$172.32	$288.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.51 / $127.48 / $219.02	Professional		$40.51	$127.48	$219.02
United Facility/Professional Professional Modifier Low / Median / High Price $134.47 / $197.14 / $348.31	Professional		$134.47	$197.14	$348.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.09 / $33.54 / $58.76	Professional	26	$23.09	$33.54	$58.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.94 / $167.55 / $288.06	Professional	TC	$111.94	$167.55	$288.06