Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.93 / $89.84 / $238.36	Facility	26	$60.93	$89.84	$238.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.45 / $268.14 / $672.91	Professional		$206.45	$268.14	$672.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.69 / $64.51 / $124.75	Professional	26	$57.69	$64.51	$124.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.76 / $191.58 / $473.43	Professional	TC	$148.76	$191.58	$473.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $145.85 / $166.69 / $166.69	Professional		$145.85	$166.69	$166.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.06 / $45.08 / $93.39	Professional	26	$33.06	$45.08	$93.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $249.95 / $303.12 / $511.37	Professional		$249.95	$303.12	$511.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.72 / $79.91 / $142.49	Professional	26	$66.72	$79.91	$142.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.90 / $224.67 / $376.23	Professional	TC	$169.90	$224.67	$376.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.99 / $149.51 / $220.05	Professional		$61.99	$149.51	$220.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $70.98	Facility	26	$68.70	$68.70	$70.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.29 / $346.09 / $660.28	Professional		$204.29	$346.09	$660.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.96 / $82.83 / $141.72	Professional	26	$55.96	$82.83	$141.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $145.47 / $258.45 / $495.33	Professional	TC	$145.47	$258.45	$495.33
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $70.98	Facility	26	$68.70	$68.70	$70.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $204.29 / $326.86 / $624.88	Professional		$204.29	$326.86	$624.88
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $57.72 / $83.72 / $138.78	Professional	26	$57.72	$83.72	$138.78
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $149.52 / $244.66 / $482.33	Professional	TC	$149.52	$244.66	$482.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $183.27 / $277.73	Professional		$40.54	$183.27	$277.73
United Facility/Professional Professional Modifier Low / Median / High Price $218.00 / $301.85 / $572.67	Professional		$218.00	$301.85	$572.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.31 / $75.47 / $144.74	Professional	26	$53.31	$75.47	$144.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.13 / $229.17 / $415.81	Professional	TC	$159.13	$229.17	$415.81