Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.50 / $174.25 / $345.54	Facility	26	$102.50	$174.25	$345.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.81 / $424.66 / $1,048.19	Professional		$339.81	$424.66	$1,048.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.50 / $118.30 / $219.33	Professional	26	$102.50	$118.30	$219.33
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $186.01 / $297.13 / $326.69	Professional	52	$186.01	$297.13	$326.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.43 / $255.57 / $465.88	Professional	TC	$229.43	$255.57	$465.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $126.05 / $126.05 / $126.05	Professional	26	$126.05	$126.05	$126.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.11 / $338.41 / $607.62	Professional		$247.11	$338.41	$607.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.43 / $120.32 / $219.29	Professional	26	$91.43	$120.32	$219.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $155.66 / $219.79 / $386.66	Professional	TC	$155.66	$219.79	$386.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $124.03 / $272.08 / $459.70	Professional		$124.03	$272.08	$459.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $320.77 / $429.17 / $705.83	Professional		$320.77	$429.17	$705.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.72 / $149.06 / $215.75	Professional	26	$101.72	$149.06	$215.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $214.20 / $293.02 / $502.69	Professional	TC	$214.20	$293.02	$502.69
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $320.77 / $442.71 / $702.59	Professional		$320.77	$442.71	$702.59
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $105.27 / $149.06 / $215.75	Professional	26	$105.27	$149.06	$215.75
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $219.06 / $298.04 / $498.83	Professional	TC	$219.06	$298.04	$498.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.04 / $257.84 / $446.08	Professional		$104.04	$257.84	$446.08
United Facility/Professional Professional Modifier Low / Median / High Price $296.11 / $405.19 / $736.44	Professional		$296.11	$405.19	$736.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.27 / $135.31 / $233.52	Professional	26	$102.27	$135.31	$233.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.26 / $279.61 / $502.92	Professional	TC	$193.26	$279.61	$502.92