Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.55 / $77.42 / $137.96	Facility	26	$42.55	$77.42	$137.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.56 / $130.54 / $196.63	Professional		$109.56	$130.54	$196.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $42.92 / $68.28	Professional	26	$37.65	$42.92	$68.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.45 / $82.82 / $128.37	Professional	TC	$69.45	$82.82	$128.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.47 / $114.14 / $137.32	Professional		$96.47	$114.14	$137.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.46 / $43.22 / $57.89	Professional	26	$38.46	$43.22	$57.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.24 / $132.63 / $215.60	Professional		$97.24	$132.63	$215.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $50.86 / $82.79	Professional	26	$38.15	$50.86	$82.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.10 / $78.30 / $136.53	Professional	TC	$53.10	$78.30	$136.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.49 / $72.01 / $133.51	Professional		$45.49	$72.01	$133.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.38 / $50.38 / $50.38	Facility	26	$50.38	$50.38	$50.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.94 / $160.21 / $340.40	Professional		$109.94	$160.21	$340.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.35 / $61.70 / $115.78	Professional	26	$41.35	$61.70	$115.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.75 / $98.95 / $221.80	Professional	TC	$67.75	$98.95	$221.80
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $50.38 / $50.38 / $50.38	Facility	26	$50.38	$50.38	$50.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $106.81 / $157.51 / $282.10	Professional		$106.81	$157.51	$282.10
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $40.71 / $60.01 / $86.84	Professional	26	$40.71	$60.01	$86.84
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $67.75 / $96.26 / $198.22	Professional	TC	$67.75	$96.26	$198.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $82.74 / $166.15	Professional		$38.81	$82.74	$166.15
United Facility/Professional Professional Modifier Low / Median / High Price $104.74 / $160.11 / $281.80	Professional		$104.74	$160.11	$281.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.15 / $57.13 / $98.12	Professional	26	$39.15	$57.13	$98.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.45 / $101.09 / $181.23	Professional	TC	$65.45	$101.09	$181.23