Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.93 / $81.18 / $173.39	Facility	26	$52.93	$81.18	$173.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.44 / $297.86 / $790.17	Professional		$244.44	$297.86	$790.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.93 / $93.06 / $314.35	Professional	26	$52.93	$93.06	$314.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $214.21 / $363.29	Professional	TC	$162.34	$214.21	$363.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $192.60 / $209.76 / $327.54	Professional		$192.60	$209.76	$327.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.03 / $62.41 / $86.87	Professional	26	$41.03	$62.41	$86.87
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $146.05 / $146.05 / $151.36	Professional	TC	$146.05	$146.05	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.59 / $280.48 / $485.00	Professional		$206.59	$280.48	$485.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.80 / $95.53 / $171.88	Professional	26	$66.80	$95.53	$171.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $126.98 / $180.69 / $301.77	Professional	TC	$126.98	$180.69	$301.77
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $233.96 / $233.96 / $304.14	Professional		$233.96	$233.96	$304.14
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $51.39 / $51.39 / $66.81	Professional	26	$51.39	$51.39	$66.81
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $182.56 / $182.56 / $237.33	Professional	TC	$182.56	$182.56	$237.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.53 / $226.31 / $327.54	Professional		$56.53	$226.31	$327.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.51 / $363.94 / $628.99	Professional		$253.51	$363.94	$628.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.96 / $86.75 / $152.66	Professional	26	$53.96	$86.75	$152.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $191.69 / $282.97 / $483.26	Professional	TC	$191.69	$282.97	$483.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $233.96 / $350.30 / $628.99	Professional		$233.96	$350.30	$628.99
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $87.36 / $161.40	Professional	26	$54.82	$87.36	$161.40
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $191.69 / $276.17 / $470.16	Professional	TC	$191.69	$276.17	$470.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $229.84 / $362.29	Professional		$40.55	$229.84	$362.29
United Facility/Professional Professional Modifier Low / Median / High Price $240.19 / $348.80 / $598.48	Professional		$240.19	$348.80	$598.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.98 / $84.12 / $139.22	Professional	26	$51.98	$84.12	$139.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $188.49 / $278.45 / $465.08	Professional	TC	$188.49	$278.45	$465.08