Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.95 / $18.95 / $22.52	Facility	26	$18.95	$18.95	$22.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.02 / $80.59 / $225.85	Professional		$67.02	$80.59	$225.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $24.67 / $45.41	Professional	26	$18.60	$24.67	$45.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.07 / $58.93 / $99.16	Professional	TC	$48.07	$58.93	$99.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.45 / $21.28 / $29.34	Professional	26	$20.45	$21.28	$29.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.89 / $81.84 / $135.83	Professional		$69.89	$81.84	$135.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.57 / $22.81 / $36.00	Professional	26	$19.57	$22.81	$36.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.31 / $58.91 / $95.58	Professional	TC	$50.31	$58.91	$95.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.36 / $63.26 / $107.03	Professional		$23.36	$63.26	$107.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	26	$18.45	$18.45	$18.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $30.78	Professional	26	$18.45	$18.45	$30.78
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.21 / $73.12 / $102.15	Professional		$54.21	$73.12	$102.15
United Facility/Professional Professional Modifier Low / Median / High Price $67.23 / $90.28 / $154.16	Professional		$67.23	$90.28	$154.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.77 / $23.48 / $39.40	Professional	26	$16.77	$23.48	$39.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.08 / $65.41 / $122.73	Professional	TC	$50.08	$65.41	$122.73