Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.93 / $107.25 / $209.40	Facility	26	$60.93	$107.25	$209.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.54 / $211.58 / $634.57	Professional		$180.54	$211.58	$634.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.69 / $64.14 / $126.83	Professional	26	$57.69	$64.14	$126.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.85 / $147.58 / $426.11	Professional	TC	$122.85	$147.58	$426.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.14 / $128.00 / $147.40	Professional		$73.14	$128.00	$147.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.06 / $50.08 / $55.44	Professional	26	$33.06	$50.08	$55.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $222.28 / $291.52 / $507.93	Professional		$222.28	$291.52	$507.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.72 / $78.29 / $140.47	Professional	26	$66.72	$78.29	$140.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $145.22 / $212.80 / $376.23	Professional	TC	$145.22	$212.80	$376.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.99 / $123.92 / $185.89	Professional		$61.99	$123.92	$185.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.36 / $68.70 / $68.70	Facility	26	$62.36	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.45 / $300.00 / $580.42	Professional		$178.45	$300.00	$580.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.22 / $82.12 / $137.80	Professional	26	$55.22	$82.12	$137.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.27 / $210.00 / $422.68	Professional	TC	$120.27	$210.00	$422.68
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $62.36 / $62.36 / $68.70	Facility	26	$62.36	$62.36	$68.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $178.45 / $298.13 / $580.42	Professional		$178.45	$298.13	$580.42
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $57.13 / $82.29 / $136.29	Professional	26	$57.13	$82.29	$136.29
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $122.04 / $195.74 / $414.08	Professional	TC	$122.04	$195.74	$414.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $150.47 / $229.76	Professional		$40.55	$150.47	$229.76
United Facility/Professional Professional Modifier Low / Median / High Price $183.62 / $260.77 / $484.37	Professional		$183.62	$260.77	$484.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.27 / $73.22 / $129.91	Professional	26	$54.27	$73.22	$129.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $122.12 / $177.30 / $336.41	Professional	TC	$122.12	$177.30	$336.41