Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.40 / $83.05 / $227.93	Facility	26	$54.40	$83.05	$227.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.16 / $285.80 / $531.45	Professional		$180.16	$285.80	$531.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.40 / $69.47 / $168.01	Professional	26	$54.40	$69.47	$168.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $126.48 / $205.59 / $369.22	Professional	TC	$126.48	$205.59	$369.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $140.51 / $140.51 / $143.24	Professional		$140.51	$140.51	$143.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.65 / $52.32 / $92.56	Professional	26	$39.65	$52.32	$92.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.51 / $290.08 / $504.36	Professional		$218.51	$290.08	$504.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.46 / $75.25 / $136.22	Professional	26	$60.46	$75.25	$136.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $149.50 / $213.75 / $376.23	Professional	TC	$149.50	$213.75	$376.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $126.50 / $188.67	Professional		$55.33	$126.50	$188.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $61.34 / $67.81	Facility	26	$61.34	$61.34	$67.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.65 / $300.00 / $573.04	Professional		$175.65	$300.00	$573.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.00 / $76.51 / $135.50	Professional	26	$50.00	$76.51	$135.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.01 / $220.71 / $422.58	Professional	TC	$125.01	$220.71	$422.58
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $61.34 / $67.81	Facility	26	$61.34	$61.34	$67.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $179.75 / $295.56 / $537.25	Professional		$179.75	$295.56	$537.25
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $52.82 / $78.84 / $145.61	Professional	26	$52.82	$78.84	$145.61
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $126.50 / $208.56 / $413.02	Professional	TC	$126.50	$208.56	$413.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $150.34 / $229.76	Professional		$40.55	$150.34	$229.76
United Facility/Professional Professional Modifier Low / Median / High Price $197.74 / $269.19 / $491.00	Professional		$197.74	$269.19	$491.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.81 / $67.84 / $124.60	Professional	26	$51.81	$67.84	$124.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.04 / $199.07 / $375.60	Professional	TC	$144.04	$199.07	$375.60