Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.20 / $104.69 / $242.98	Facility	26	$73.20	$104.69	$242.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.59 / $425.00 / $988.57	Professional		$338.59	$425.00	$988.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.25 / $119.35 / $230.97	Professional	26	$71.25	$119.35	$230.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $331.17 / $631.87	Professional	TC	$259.35	$331.17	$631.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.71 / $247.59 / $627.07	Professional		$158.71	$247.59	$627.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.82 / $68.45 / $92.16	Professional	26	$51.82	$68.45	$92.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $369.67 / $450.81 / $753.84	Professional		$369.67	$450.81	$753.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.08 / $98.05 / $180.95	Professional	26	$77.08	$98.05	$180.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $285.00 / $342.69 / $591.94	Professional	TC	$285.00	$342.69	$591.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.48 / $282.31 / $424.51	Professional		$71.48	$282.31	$424.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.39 / $80.26 / $80.26	Facility	26	$72.39	$80.26	$80.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $320.45 / $639.64 / $1,346.74	Professional		$320.45	$639.64	$1,346.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.40 / $99.87 / $184.32	Professional	26	$65.40	$99.87	$184.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $255.06 / $508.36 / $1,164.51	Professional	TC	$255.06	$508.36	$1,164.51
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $72.39 / $72.39 / $80.26	Facility	26	$72.39	$72.39	$80.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $320.45 / $615.12 / $1,422.53	Professional		$320.45	$615.12	$1,422.53
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $69.67 / $104.46 / $190.29	Professional	26	$69.67	$104.46	$190.29
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $258.19 / $441.45 / $1,112.33	Professional	TC	$258.19	$441.45	$1,112.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.67 / $259.31 / $411.17	Professional		$65.67	$259.31	$411.17
United Facility/Professional Professional Modifier Low / Median / High Price $339.75 / $527.16 / $1,086.73	Professional		$339.75	$527.16	$1,086.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.86 / $85.84 / $156.18	Professional	26	$59.86	$85.84	$156.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $267.70 / $389.27 / $916.57	Professional	TC	$267.70	$389.27	$916.57