Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.68 / $44.90 / $102.95	Facility	26	$32.68	$44.90	$102.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $97.48 / $170.34	Professional		$64.31	$97.48	$170.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.58 / $33.61 / $59.56	Professional	26	$29.58	$33.61	$59.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $64.03 / $113.73	Professional	TC	$33.03	$64.03	$113.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.53 / $31.89 / $39.09	Professional	26	$29.53	$31.89	$39.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.85 / $64.59 / $122.62	Professional		$44.85	$64.59	$122.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.11 / $39.04 / $62.41	Professional	26	$30.11	$39.04	$62.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.81 / $19.53 / $77.69	Professional	TC	$11.81	$19.53	$77.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $37.52 / $77.81 / $125.13	Professional		$37.52	$77.81	$125.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.61 / $38.61 / $38.61	Facility	26	$38.61	$38.61	$38.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.94 / $110.90 / $198.49	Professional		$68.94	$110.90	$198.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.75 / $46.31 / $88.91	Professional	26	$31.75	$46.31	$88.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.49 / $70.03 / $137.08	Professional	TC	$25.49	$70.03	$137.08
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $38.61 / $38.61 / $38.61	Facility	26	$38.61	$38.61	$38.61
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $72.02 / $112.46 / $179.27	Professional		$72.02	$112.46	$179.27
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $31.75 / $45.93 / $65.70	Professional	26	$31.75	$45.93	$65.70
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $30.79 / $71.83 / $125.68	Professional	TC	$30.79	$71.83	$125.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $78.19 / $127.75	Professional		$39.86	$78.19	$127.75
United Facility/Professional Professional Modifier Low / Median / High Price $60.73 / $103.68 / $190.95	Professional		$60.73	$103.68	$190.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $44.58 / $73.87	Professional	26	$30.20	$44.58	$73.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.95 / $61.31 / $117.08	Professional	TC	$20.95	$61.31	$117.08