Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.95 / $32.35 / $74.12	Facility	26	$22.95	$32.35	$74.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.40 / $177.34 / $411.49	Professional		$147.40	$177.34	$411.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.49 / $26.24 / $51.55	Professional	26	$22.49	$26.24	$51.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $124.45 / $148.82 / $361.66	Professional	TC	$124.45	$148.82	$361.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $297.93 / $297.93 / $297.93	Professional		$297.93	$297.93	$297.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.14 / $24.49 / $33.39	Professional	26	$17.14	$24.49	$33.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.34 / $220.64 / $394.81	Professional		$160.34	$220.64	$394.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.27 / $29.20 / $50.92	Professional	26	$22.27	$29.20	$50.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.22 / $191.33 / $339.89	Professional	TC	$138.22	$191.33	$339.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.49 / $132.06 / $175.81	Professional		$24.49	$132.06	$175.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.68 / $216.19 / $358.38	Professional		$145.68	$216.19	$358.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.28 / $32.13 / $48.36	Professional	26	$23.28	$32.13	$48.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.01 / $186.08 / $306.25	Professional	TC	$125.01	$186.08	$306.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $142.91 / $205.60 / $338.26	Professional		$142.91	$205.60	$338.26
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $23.38 / $32.28 / $47.56	Professional	26	$23.38	$32.28	$47.56
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $125.01 / $181.83 / $302.67	Professional	TC	$125.01	$181.83	$302.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $149.92 / $229.96	Professional		$40.43	$149.92	$229.96
United Facility/Professional Professional Modifier Low / Median / High Price $140.10 / $199.21 / $359.00	Professional		$140.10	$199.21	$359.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.47 / $29.87 / $52.79	Professional	26	$21.47	$29.87	$52.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.25 / $174.85 / $296.83	Professional	TC	$120.25	$174.85	$296.83