Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.69 / $126.83 / $296.18	Facility	26	$88.69	$126.83	$296.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.45 / $461.27 / $813.98	Professional		$355.45	$461.27	$813.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.81 / $131.34 / $258.33	Professional	26	$86.81	$131.34	$258.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $335.00 / $622.77	Professional	TC	$259.35	$335.00	$622.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $203.92 / $260.33 / $579.25	Professional		$203.92	$260.33	$579.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.04 / $83.25 / $112.07	Professional	26	$64.04	$83.25	$112.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $372.19 / $454.57 / $753.84	Professional		$372.19	$454.57	$753.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.99 / $101.57 / $185.36	Professional	26	$84.99	$101.57	$185.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $285.00 / $343.97 / $591.94	Professional	TC	$285.00	$343.97	$591.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.06 / $259.16 / $394.58	Professional		$88.06	$259.16	$394.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.20 / $97.25 / $97.25	Facility	26	$88.20	$97.25	$97.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.59 / $658.99 / $1,346.74	Professional		$335.59	$658.99	$1,346.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.92 / $115.64 / $196.56	Professional	26	$73.92	$115.64	$196.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $256.32 / $511.90 / $1,165.49	Professional	TC	$256.32	$511.90	$1,165.49
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $88.20 / $88.20 / $97.25	Facility	26	$88.20	$88.20	$97.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $331.44 / $595.09 / $1,412.89	Professional		$331.44	$595.09	$1,412.89
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $82.38 / $120.82 / $212.92	Professional	26	$82.38	$120.82	$212.92
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $259.16 / $444.13 / $1,113.29	Professional	TC	$259.16	$444.13	$1,113.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $280.41 / $469.22	Professional		$98.87	$280.41	$469.22
United Facility/Professional Professional Modifier Low / Median / High Price $342.58 / $519.74 / $1,014.21	Professional		$342.58	$519.74	$1,014.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.14 / $99.29 / $178.81	Professional	26	$71.14	$99.29	$178.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $265.82 / $412.87 / $886.12	Professional	TC	$265.82	$412.87	$886.12