Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.94 / $148.31 / $351.88	Facility	26	$105.94	$148.31	$351.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.74 / $475.00 / $1,053.67	Professional		$349.74	$475.00	$1,053.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.32 / $140.02 / $355.10	Professional	26	$103.32	$140.02	$355.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $243.80 / $335.00 / $711.65	Professional	TC	$243.80	$335.00	$711.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $235.70 / $264.00 / $480.45	Professional		$235.70	$264.00	$480.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.00 / $125.11 / $168.42	Professional	26	$77.00	$125.11	$168.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $362.52 / $465.88 / $791.39	Professional		$362.52	$465.88	$791.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.52 / $114.26 / $216.77	Professional	26	$77.52	$114.26	$216.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $266.24 / $342.00 / $568.71	Professional	TC	$266.24	$342.00	$568.71
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $366.50 / $403.77 / $568.38	Professional		$366.50	$403.77	$568.38
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $113.56 / $125.11 / $176.12	Professional	26	$113.56	$125.11	$176.12
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $252.93 / $278.66 / $392.26	Professional	TC	$252.93	$278.66	$392.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $105.86 / $270.49 / $449.03	Professional		$105.86	$270.49	$449.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.76 / $116.17 / $116.17	Facility	26	$104.76	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.97 / $591.27 / $1,214.78	Professional		$328.97	$591.27	$1,214.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.29 / $137.18 / $229.03	Professional	26	$88.29	$137.18	$229.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.31 / $430.03 / $1,041.68	Professional	TC	$234.31	$430.03	$1,041.68
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $104.76 / $104.76 / $116.17	Facility	26	$104.76	$104.76	$116.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $328.97 / $575.13 / $1,335.63	Professional		$328.97	$575.13	$1,335.63
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $100.66 / $146.30 / $284.56	Professional	26	$100.66	$146.30	$284.56
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $235.78 / $403.81 / $969.75	Professional	TC	$235.78	$403.81	$969.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $247.52 / $425.35	Professional		$98.87	$247.52	$425.35
United Facility/Professional Professional Modifier Low / Median / High Price $341.65 / $474.65 / $986.58	Professional		$341.65	$474.65	$986.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $90.18 / $120.56 / $214.98	Professional	26	$90.18	$120.56	$214.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $248.86 / $349.36 / $843.26	Professional	TC	$248.86	$349.36	$843.26