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 $249.27 / $336.46 / $719.37	Professional		$249.27	$336.46	$719.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $106.01 / $259.91	Professional	26	$77.62	$106.01	$259.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $226.77 / $566.60	Professional	TC	$170.48	$226.77	$566.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.05 / $221.12 / $276.38	Professional		$91.05	$221.12	$276.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.28 / $81.64 / $143.22	Professional	26	$62.28	$81.64	$143.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $277.17 / $338.39 / $560.67	Professional		$277.17	$338.39	$560.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.06 / $98.85 / $181.85	Professional	26	$84.06	$98.85	$181.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $229.90 / $386.92	Professional	TC	$190.00	$229.90	$386.92
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $298.89 / $298.89 / $329.29	Professional		$298.89	$298.89	$329.29
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $91.85 / $91.85 / $101.19	Professional	26	$91.85	$91.85	$101.19
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $207.03 / $207.03 / $228.09	Professional	TC	$207.03	$207.03	$228.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.62 / $221.29 / $354.62	Professional		$85.62	$221.29	$354.62
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 $264.43 / $429.82 / $864.81	Professional		$264.43	$429.82	$864.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.86 / $111.21 / $187.25	Professional	26	$71.86	$111.21	$187.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.99 / $315.81 / $683.38	Professional	TC	$181.99	$315.81	$683.38
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 $253.30 / $417.94 / $848.90	Professional		$253.30	$417.94	$848.90
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $81.73 / $122.38 / $250.13	Professional	26	$81.73	$122.38	$250.13
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $181.99 / $289.49 / $683.38	Professional	TC	$181.99	$289.49	$683.38
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 $262.83 / $379.19 / $730.13	Professional		$262.83	$379.19	$730.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.88 / $98.23 / $178.94	Professional	26	$67.88	$98.23	$178.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $182.98 / $249.26 / $556.55	Professional	TC	$182.98	$249.26	$556.55