Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.40 / $96.00 / $187.42	Facility	26	$54.40	$96.00	$187.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.01 / $181.79 / $429.12	Professional		$149.01	$181.79	$429.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.19 / $56.66 / $112.06	Professional	26	$50.19	$56.66	$112.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.61 / $119.70 / $302.37	Professional	TC	$94.61	$119.70	$302.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.33 / $58.11 / $125.77	Professional		$56.33	$58.11	$125.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.24 / $50.53 / $88.03	Professional	26	$40.24	$50.53	$88.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.45 / $237.63 / $457.13	Professional		$174.45	$237.63	$457.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.39 / $63.67 / $113.06	Professional	26	$56.39	$63.67	$113.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $112.16 / $179.74 / $332.51	Professional	TC	$112.16	$179.74	$332.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $95.06 / $150.38	Professional		$55.33	$95.06	$150.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.69 / $61.34 / $61.34	Facility	26	$55.69	$61.34	$61.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.56 / $231.39 / $458.30	Professional		$143.56	$231.39	$458.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.62 / $71.81 / $121.19	Professional	26	$46.62	$71.81	$121.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.74 / $152.41 / $308.48	Professional	TC	$90.74	$152.41	$308.48
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $55.69 / $55.69 / $61.34	Facility	26	$55.69	$55.69	$61.34
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $143.56 / $225.75 / $464.41	Professional		$143.56	$225.75	$464.41
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $51.00 / $73.00 / $136.63	Professional	26	$51.00	$73.00	$136.63
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $92.86 / $146.82 / $302.58	Professional	TC	$92.86	$146.82	$302.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $115.99 / $179.83	Professional		$40.55	$115.99	$179.83
United Facility/Professional Professional Modifier Low / Median / High Price $145.62 / $199.60 / $364.00	Professional		$145.62	$199.60	$364.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.32 / $63.75 / $115.48	Professional	26	$47.32	$63.75	$115.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.38 / $128.49 / $254.92	Professional	TC	$92.38	$128.49	$254.92