Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.53 / $95.14 / $222.19	Facility	26	$66.53	$95.14	$222.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.32 / $375.00 / $674.76	Professional		$233.32	$375.00	$674.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.15 / $111.15 / $154.00	Professional	26	$65.15	$111.15	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $166.79 / $266.86 / $557.00	Professional	TC	$166.79	$266.86	$557.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.69 / $179.09 / $232.02	Professional		$156.69	$179.09	$232.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.14 / $77.77 / $110.06	Professional	26	$47.14	$77.77	$110.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $282.32 / $365.88 / $687.24	Professional		$282.32	$365.88	$687.24
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.59 / $76.70 / $136.34	Professional	26	$64.59	$76.70	$136.34
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $200.04 / $291.24 / $553.48	Professional	TC	$200.04	$291.24	$553.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.80 / $161.51 / $253.21	Professional		$65.80	$161.51	$253.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.08 / $72.95 / $72.95	Facility	26	$66.08	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.64 / $391.83 / $784.97	Professional		$219.64	$391.83	$784.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.44 / $85.19 / $144.62	Professional	26	$55.44	$85.19	$144.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.08 / $308.33 / $643.91	Professional	TC	$157.08	$308.33	$643.91
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $66.08 / $66.08 / $72.95	Facility	26	$66.08	$66.08	$72.95
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $216.98 / $383.39 / $784.97	Professional		$216.98	$383.39	$784.97
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $60.65 / $86.73 / $144.62	Professional	26	$60.65	$86.73	$144.62
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $161.51 / $275.52 / $607.64	Professional	TC	$161.51	$275.52	$607.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $183.60 / $277.73	Professional		$40.54	$183.60	$277.73
United Facility/Professional Professional Modifier Low / Median / High Price $229.57 / $329.73 / $645.87	Professional		$229.57	$329.73	$645.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.91 / $75.48 / $132.72	Professional	26	$55.91	$75.48	$132.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.12 / $231.65 / $503.40	Professional	TC	$167.12	$231.65	$503.40