Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.25 / $106.18 / $247.61	Facility	26	$74.25	$106.18	$247.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.53 / $370.50 / $700.00	Professional		$253.53	$370.50	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.23 / $107.99 / $155.65	Professional	26	$72.23	$107.99	$155.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $179.61 / $259.35 / $380.77	Professional	TC	$179.61	$259.35	$380.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.71 / $122.86 / $122.86	Professional	26	$53.71	$122.86	$122.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $283.17 / $397.11 / $690.39	Professional		$283.17	$397.11	$690.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.14 / $72.98 / $126.07	Professional	26	$59.14	$72.98	$126.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $206.31 / $319.20 / $564.30	Professional	TC	$206.31	$319.20	$564.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.45 / $174.85 / $274.92	Professional		$73.45	$174.85	$274.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.62 / $81.40 / $81.40	Facility	26	$73.62	$81.40	$81.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.90 / $442.12 / $854.93	Professional		$238.90	$442.12	$854.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.56 / $86.80 / $157.50	Professional	26	$57.56	$86.80	$157.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.55 / $342.77 / $727.24	Professional	TC	$172.55	$342.77	$727.24
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $73.62 / $73.62 / $81.40	Facility	26	$73.62	$73.62	$81.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $238.90 / $437.49 / $854.93	Professional		$238.90	$437.49	$854.93
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $64.63 / $87.31 / $157.50	Professional	26	$64.63	$87.31	$157.50
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $174.23 / $308.00 / $720.50	Professional	TC	$174.23	$308.00	$720.50
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 $240.78 / $338.59 / $719.82	Professional		$240.78	$338.59	$719.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.61 / $79.14 / $148.85	Professional	26	$55.61	$79.14	$148.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $172.34 / $261.52 / $583.48	Professional	TC	$172.34	$261.52	$583.48