Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.54 / $62.11 / $119.30	Facility	26	$36.54	$62.11	$119.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.66 / $219.03 / $651.32	Professional		$133.66	$219.03	$651.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $58.00 / $174.28	Professional	26	$36.54	$58.00	$174.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.12 / $162.12 / $274.97	Professional	TC	$97.12	$162.12	$274.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.57 / $113.68 / $149.55	Professional		$113.57	$113.68	$149.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.88 / $31.53 / $60.26	Professional	26	$27.88	$31.53	$60.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.46 / $209.36 / $389.99	Professional		$164.46	$209.36	$389.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.25 / $63.88 / $113.67	Professional	26	$45.25	$63.88	$113.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $113.21 / $145.49 / $270.13	Professional	TC	$113.21	$145.49	$270.13
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $141.96 / $141.96 / $184.55	Professional		$141.96	$141.96	$184.55
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $35.46 / $35.46 / $46.10	Professional	26	$35.46	$35.46	$46.10
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $106.50 / $106.50 / $138.44	Professional	TC	$106.50	$106.50	$138.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.01 / $133.16 / $198.74	Professional		$39.01	$133.16	$198.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.06 / $220.04 / $365.69	Professional		$149.06	$220.04	$365.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.24 / $57.77 / $100.69	Professional	26	$37.24	$57.77	$100.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.82 / $162.54 / $267.14	Professional	TC	$111.82	$162.54	$267.14
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $144.63 / $207.31 / $355.34	Professional		$144.63	$207.31	$355.34
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $37.70 / $58.52 / $108.24	Professional	26	$37.70	$58.52	$108.24
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $111.94 / $160.22 / $259.62	Professional	TC	$111.94	$160.22	$259.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.46 / $126.02 / $217.81	Professional		$40.46	$126.02	$217.81
United Facility/Professional Professional Modifier Low / Median / High Price $142.34 / $204.84 / $350.60	Professional		$142.34	$204.84	$350.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $54.98 / $91.53	Professional	26	$34.65	$54.98	$91.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.72 / $149.63 / $257.17	Professional	TC	$106.72	$149.63	$257.17