Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $16.07 / $38.09	Facility	26	$11.48	$16.07	$38.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.84 / $102.58 / $210.59	Professional		$75.84	$102.58	$210.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.16 / $13.26 / $33.51	Professional	26	$11.16	$13.26	$33.51
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.93 / $40.14 / $121.86	Professional	52	$37.93	$40.14	$121.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.37 / $92.99 / $173.90	Professional	TC	$64.37	$92.99	$173.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.67 / $64.28 / $95.04	Professional		$60.67	$64.28	$95.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $11.37 / $18.48	Professional	26	$8.77	$11.37	$18.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.35 / $116.63 / $204.07	Professional		$89.35	$116.63	$204.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.64 / $13.95 / $24.56	Professional	26	$10.64	$13.95	$24.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.17 / $102.47 / $181.85	Professional	TC	$76.17	$102.47	$181.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.27 / $73.11 / $105.29	Professional		$12.27	$73.11	$105.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.98 / $112.82 / $185.47	Professional		$74.98	$112.82	$185.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.42 / $16.10 / $23.84	Professional	26	$11.42	$16.10	$23.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.45 / $98.62 / $164.13	Professional	TC	$63.45	$98.62	$164.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $71.27 / $106.18 / $183.58	Professional		$71.27	$106.18	$183.58
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $11.71 / $16.52 / $24.53	Professional	26	$11.71	$16.52	$24.53
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $63.31 / $96.04 / $163.16	Professional	TC	$63.31	$96.04	$163.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.96 / $71.16 / $100.41	Professional		$51.96	$71.16	$100.41
United Facility/Professional Professional Modifier Low / Median / High Price $73.36 / $107.30 / $188.64	Professional		$73.36	$107.30	$188.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $15.29 / $27.15	Professional	26	$10.83	$15.29	$27.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.59 / $92.04 / $158.68	Professional	TC	$62.59	$92.04	$158.68