Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.12 / $84.54 / $197.85	Facility	26	$59.12	$84.54	$197.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.82 / $370.50 / $525.00	Professional		$233.82	$370.50	$525.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.12 / $99.39 / $154.00	Professional	26	$59.12	$99.39	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $174.69 / $259.35 / $374.27	Professional	TC	$174.69	$259.35	$374.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.15 / $171.15 / $171.15	Professional		$171.15	$171.15	$171.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.94 / $41.94 / $41.94	Professional	26	$41.94	$41.94	$41.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $270.37 / $392.66 / $690.39	Professional		$270.37	$392.66	$690.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.89 / $67.53 / $124.28	Professional	26	$56.89	$67.53	$124.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $205.91 / $319.20 / $564.30	Professional	TC	$205.91	$319.20	$564.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.48 / $170.30 / $253.48	Professional		$58.48	$170.30	$253.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.86 / $64.84 / $64.84	Facility	26	$58.86	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.66 / $428.90 / $822.00	Professional		$220.66	$428.90	$822.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.28 / $76.64 / $131.41	Professional	26	$49.28	$76.64	$131.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.82 / $335.09 / $713.53	Professional	TC	$167.82	$335.09	$713.53
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $58.86 / $58.86 / $64.84	Facility	26	$58.86	$58.86	$64.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $220.66 / $415.10 / $822.00	Professional		$220.66	$415.10	$822.00
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $53.90 / $77.73 / $139.50	Professional	26	$53.90	$77.73	$139.50
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $170.31 / $298.42 / $695.38	Professional	TC	$170.31	$298.42	$695.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $196.97 / $313.88	Professional		$40.55	$196.97	$313.88
United Facility/Professional Professional Modifier Low / Median / High Price $225.70 / $339.29 / $686.88	Professional		$225.70	$339.29	$686.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.11 / $63.15 / $118.78	Professional	26	$46.11	$63.15	$118.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $170.57 / $238.63 / $554.16	Professional	TC	$170.57	$238.63	$554.16