Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.84 / $119.89 / $288.12	Facility	26	$83.84	$119.89	$288.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.51 / $367.73 / $718.79	Professional		$251.51	$367.73	$718.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.84 / $106.03 / $251.09	Professional	26	$77.84	$106.03	$251.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $255.71 / $566.60	Professional	TC	$170.48	$255.71	$566.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.72 / $209.03 / $266.52	Professional		$158.72	$209.03	$266.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.01 / $87.89 / $143.22	Professional	26	$62.01	$87.89	$143.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $292.73 / $292.73 / $292.73	Professional	TC	$292.73	$292.73	$292.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $277.17 / $333.91 / $560.67	Professional		$277.17	$333.91	$560.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.29 / $99.54 / $182.08	Professional	26	$83.29	$99.54	$182.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $229.90 / $387.33	Professional	TC	$190.00	$229.90	$387.33
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $299.24 / $299.24 / $332.20	Professional		$299.24	$299.24	$332.20
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $91.85 / $91.85 / $101.97	Professional	26	$91.85	$91.85	$101.97
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $207.39 / $207.39 / $230.23	Professional	TC	$207.39	$207.39	$230.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.62 / $221.65 / $355.03	Professional		$85.62	$221.65	$355.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.75 / $94.56 / $94.56	Facility	26	$85.75	$94.56	$94.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.74 / $428.39 / $865.80	Professional		$264.74	$428.39	$865.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.86 / $111.10 / $187.25	Professional	26	$71.86	$111.10	$187.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $182.30 / $308.39 / $662.77	Professional	TC	$182.30	$308.39	$662.77
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $85.75 / $85.75 / $94.56	Facility	26	$85.75	$85.75	$94.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $264.74 / $431.10 / $845.10	Professional		$264.74	$431.10	$845.10
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $81.73 / $122.38 / $239.54	Professional	26	$81.73	$122.38	$239.54
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $184.53 / $285.73 / $662.77	Professional	TC	$184.53	$285.73	$662.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $180.48 / $337.88	Professional		$98.87	$180.48	$337.88
United Facility/Professional Professional Modifier Low / Median / High Price $263.43 / $361.89 / $729.29	Professional		$263.43	$361.89	$729.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.28 / $99.10 / $175.62	Professional	26	$71.28	$99.10	$175.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.28 / $273.64 / $544.01	Professional	TC	$183.28	$273.64	$544.01