Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $30.90 / $60.26	Facility	26	$22.91	$30.90	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $194.98 / $457.09	Professional		$144.54	$194.98	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.20 / $74.13	Professional	26	$21.88	$30.20	$74.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $154.88 / $363.08	Professional	TC	$123.03	$154.88	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $162.18 / $208.93	Professional		$141.25	$162.18	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $24.55 / $35.48	Professional	26	$19.95	$24.55	$35.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $245.47 / $398.11	Professional		$177.83	$245.47	$398.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.90 / $51.29	Professional	26	$22.91	$30.90	$51.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $213.80 / $354.81	Professional	TC	$154.88	$213.80	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $346.74	Professional		$144.54	$218.78	$346.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $31.62 / $48.98	Professional	26	$22.91	$31.62	$48.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $186.21 / $316.23	Professional	TC	$123.03	$186.21	$316.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $204.17 / $346.74	Professional		$141.25	$204.17	$346.74
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $30.90 / $47.86	Professional	26	$22.39	$30.90	$47.86
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $181.97 / $309.03	Professional	TC	$123.03	$181.97	$309.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $33.11 / $109.65	Professional		$27.54	$33.11	$109.65
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $354.81	Professional		$158.49	$199.53	$354.81
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.20 / $53.70	Professional	26	$24.55	$30.20	$53.70
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $169.82 / $302.00	Professional	TC	$134.90	$169.82	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $331.13	Professional		$134.90	$190.55	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $27.54 / $51.29	Professional	26	$20.42	$27.54	$51.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $165.96 / $288.40	Professional	TC	$117.49	$165.96	$288.40