Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.05 / $75.66 / $173.27	Facility	26	$54.05	$75.66	$173.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.02 / $362.96 / $663.25	Professional		$286.02	$362.96	$663.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.40 / $57.29 / $101.15	Professional	26	$50.40	$57.29	$101.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.26 / $308.91 / $529.78	Professional	TC	$239.26	$308.91	$529.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $303.18 / $334.02 / $373.09	Professional		$303.18	$334.02	$373.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $65.23 / $80.88	Professional	26	$51.38	$65.23	$80.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.57 / $250.24 / $470.92	Professional		$164.57	$250.24	$470.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.74 / $62.22 / $99.23	Professional	26	$45.74	$62.22	$99.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $113.81 / $174.07 / $389.39	Professional	TC	$113.81	$174.07	$389.39
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $345.84 / $345.84 / $518.76	Professional		$345.84	$345.84	$518.76
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $52.18 / $52.18 / $78.27	Professional	26	$52.18	$52.18	$78.27
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $293.66 / $293.66 / $440.49	Professional	TC	$293.66	$293.66	$440.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.72 / $355.78 / $473.81	Professional		$61.72	$355.78	$473.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.86 / $444.51 / $865.42	Professional		$274.86	$444.51	$865.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.18 / $75.79 / $135.19	Professional	26	$52.18	$75.79	$135.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.69 / $375.97 / $721.50	Professional	TC	$194.69	$375.97	$721.50
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $157.37 / $415.01 / $639.11	Professional		$157.37	$415.01	$639.11
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $53.23 / $74.08 / $114.34	Professional	26	$53.23	$74.08	$114.34
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $222.29 / $378.82 / $578.26	Professional	TC	$222.29	$378.82	$578.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.91 / $308.10 / $486.21	Professional		$62.91	$308.10	$486.21
United Facility/Professional Professional Modifier Low / Median / High Price $254.69 / $415.01 / $729.26	Professional		$254.69	$415.01	$729.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.63 / $72.97 / $122.40	Professional	26	$48.63	$72.97	$122.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.58 / $343.78 / $606.86	Professional	TC	$196.58	$343.78	$606.86