Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.28 / $103.64 / $185.56	Facility	26	$57.28	$103.64	$185.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.75 / $133.04 / $328.90	Professional		$108.75	$133.04	$328.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.33 / $61.74 / $123.34	Professional	26	$56.33	$61.74	$123.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.11 / $65.70 / $162.35	Professional	TC	$53.11	$65.70	$162.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.55 / $85.55 / $85.55	Professional		$85.55	$85.55	$85.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.90 / $173.50 / $322.10	Professional		$132.90	$173.50	$322.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.60 / $72.28 / $126.12	Professional	26	$55.60	$72.28	$126.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $70.08 / $104.48 / $183.86	Professional	TC	$70.08	$104.48	$183.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.44 / $64.14 / $133.66	Professional		$56.44	$64.14	$133.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.28 / $171.09 / $291.77	Professional		$112.28	$171.09	$291.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.45 / $78.41 / $119.35	Professional	26	$57.45	$78.41	$119.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.25 / $87.23 / $173.61	Professional	TC	$54.25	$87.23	$173.61
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $110.62 / $165.75 / $291.77	Professional		$110.62	$165.75	$291.77
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $58.40 / $80.19 / $119.03	Professional	26	$58.40	$80.19	$119.03
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $53.88 / $83.56 / $165.89	Professional	TC	$53.88	$83.56	$165.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $81.79 / $131.21	Professional		$40.54	$81.79	$131.21
United Facility/Professional Professional Modifier Low / Median / High Price $108.53 / $169.28 / $278.04	Professional		$108.53	$169.28	$278.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.42 / $75.09 / $131.21	Professional	26	$52.42	$75.09	$131.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.45 / $92.07 / $149.72	Professional	TC	$52.45	$92.07	$149.72