Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.88 / $120.60 / $241.90	Facility	26	$72.88	$120.60	$241.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $272.08 / $370.50 / $700.00	Professional		$272.08	$370.50	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.87 / $111.15 / $155.65	Professional	26	$70.87	$111.15	$155.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.21 / $259.35 / $557.00	Professional	TC	$199.21	$259.35	$557.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.63 / $197.53 / $207.90	Professional		$154.63	$197.53	$207.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.43 / $52.43 / $64.48	Professional	26	$52.43	$52.43	$64.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.27 / $353.09 / $692.90	Professional		$288.27	$353.09	$692.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.54 / $83.26 / $152.44	Professional	26	$69.54	$83.26	$152.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $217.47 / $267.80 / $533.27	Professional	TC	$217.47	$267.80	$533.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.08 / $191.38 / $297.58	Professional		$72.08	$191.38	$297.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.06 / $79.91 / $79.91	Facility	26	$72.06	$79.91	$79.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.59 / $429.68 / $834.97	Professional		$254.59	$429.68	$834.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.72 / $94.65 / $158.38	Professional	26	$60.72	$94.65	$158.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $191.38 / $326.44 / $614.53	Professional	TC	$191.38	$326.44	$614.53
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $72.06 / $72.06 / $79.91	Facility	26	$72.06	$72.06	$79.91
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $256.58 / $429.68 / $834.97	Professional		$256.58	$429.68	$834.97
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $66.44 / $96.37 / $154.63	Professional	26	$66.44	$96.37	$154.63
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $191.50 / $313.16 / $612.77	Professional	TC	$191.50	$313.16	$612.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.67 / $196.83 / $317.01	Professional		$65.67	$196.83	$317.01
United Facility/Professional Professional Modifier Low / Median / High Price $269.48 / $371.27 / $646.30	Professional		$269.48	$371.27	$646.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.36 / $78.80 / $145.27	Professional	26	$57.36	$78.80	$145.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $206.51 / $268.56 / $504.45	Professional	TC	$206.51	$268.56	$504.45