Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.24 / $87.57 / $209.40	Facility	26	$61.24	$87.57	$209.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.32 / $222.35 / $557.41	Professional		$172.32	$222.35	$557.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $65.70 / $169.57	Professional	26	$55.00	$65.70	$169.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $113.12 / $145.47 / $388.16	Professional	TC	$113.12	$145.47	$388.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.77 / $131.50 / $167.23	Professional		$120.77	$131.50	$167.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.31 / $59.40 / $99.12	Professional	26	$45.31	$59.40	$99.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.02 / $263.27 / $493.92	Professional		$206.02	$263.27	$493.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.70 / $71.67 / $128.29	Professional	26	$63.70	$71.67	$128.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $134.66 / $190.00 / $376.23	Professional	TC	$134.66	$190.00	$376.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $131.33 / $226.33	Professional		$62.30	$131.33	$226.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.36 / $69.05 / $69.05	Facility	26	$62.36	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $168.05 / $273.80 / $535.16	Professional		$168.05	$273.80	$535.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $80.97 / $137.00	Professional	26	$52.48	$80.97	$137.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.88 / $185.18 / $369.34	Professional	TC	$109.88	$185.18	$369.34
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $62.36 / $62.36 / $69.05	Facility	26	$62.36	$62.36	$69.05
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $168.05 / $271.25 / $545.91	Professional		$168.05	$271.25	$545.91
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $58.24 / $84.96 / $146.66	Professional	26	$58.24	$84.96	$146.66
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $111.17 / $176.70 / $362.04	Professional	TC	$111.17	$176.70	$362.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $127.48 / $219.02	Professional		$40.55	$127.48	$219.02
United Facility/Professional Professional Modifier Low / Median / High Price $171.25 / $233.60 / $421.77	Professional		$171.25	$233.60	$421.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.31 / $71.45 / $129.91	Professional	26	$50.31	$71.45	$129.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.59 / $148.58 / $283.23	Professional	TC	$111.59	$148.58	$283.23