Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.61 / $38.43 / $74.12	Facility	26	$22.61	$38.43	$74.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.70 / $128.43 / $222.42	Professional		$113.70	$128.43	$222.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.51 / $24.81 / $49.05	Professional	26	$14.51	$24.81	$49.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.66 / $111.82 / $175.23	Professional	TC	$91.66	$111.82	$175.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.78 / $95.75 / $98.26	Professional		$83.78	$95.75	$98.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.78 / $21.82 / $35.86	Professional	26	$16.78	$21.82	$35.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.35 / $127.40 / $219.16	Professional		$93.35	$127.40	$219.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.50 / $19.72 / $33.01	Professional	26	$13.50	$19.72	$33.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.84 / $107.94 / $187.45	Professional	TC	$79.84	$107.94	$187.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.80 / $96.68 / $130.01	Professional		$23.80	$96.68	$130.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.00 / $163.28 / $278.50	Professional		$115.00	$163.28	$278.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.76 / $25.81 / $45.43	Professional	26	$17.76	$25.81	$45.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.91 / $137.04 / $244.52	Professional	TC	$92.91	$137.04	$244.52
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $114.94 / $161.88 / $253.99	Professional		$114.94	$161.88	$253.99
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $26.40 / $45.29	Professional	26	$20.30	$26.40	$45.29
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $92.29 / $135.88 / $234.52	Professional	TC	$92.29	$135.88	$234.52
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 $109.15 / $158.04 / $278.64	Professional		$109.15	$158.04	$278.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.66 / $26.78 / $52.04	Professional	26	$15.66	$26.78	$52.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.12 / $132.63 / $229.62	Professional	TC	$90.12	$132.63	$229.62