Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.21 / $77.42 / $135.90	Facility	26	$42.21	$77.42	$135.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.68 / $82.58 / $110.30	Professional		$68.68	$82.58	$110.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.85 / $42.21 / $56.98	Professional	26	$36.85	$42.21	$56.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.59 / $40.36 / $52.55	Professional	TC	$31.59	$40.36	$52.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.87 / $83.78 / $102.17	Professional		$70.87	$83.78	$102.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.62 / $79.86 / $129.36	Professional		$52.62	$79.86	$129.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.65 / $49.22 / $78.97	Professional	26	$36.65	$49.22	$78.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.14 / $21.37 / $53.86	Professional	TC	$13.14	$21.37	$53.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.86 / $47.56 / $98.84	Professional		$41.86	$47.56	$98.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $109.12 / $202.83	Professional		$73.20	$109.12	$202.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.02 / $60.91 / $114.30	Professional	26	$41.02	$60.91	$114.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.15 / $49.47 / $94.71	Professional	TC	$30.15	$49.47	$94.71
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $70.26 / $105.69 / $157.57	Professional		$70.26	$105.69	$157.57
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $41.02 / $60.01 / $85.42	Professional	26	$41.02	$60.01	$85.42
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $31.02 / $49.47 / $76.72	Professional	TC	$31.02	$49.47	$76.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.36 / $46.80 / $125.10	Professional		$28.36	$46.80	$125.10
United Facility/Professional Professional Modifier Low / Median / High Price $68.12 / $103.17 / $176.47	Professional		$68.12	$103.17	$176.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.14 / $56.68 / $95.14	Professional	26	$38.14	$56.68	$95.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.82 / $44.09 / $79.95	Professional	TC	$29.82	$44.09	$79.95