Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.97 / $150.49 / $293.82	Facility	26	$87.97	$150.49	$293.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.12 / $425.00 / $843.88	Professional		$279.12	$425.00	$843.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.09 / $126.00 / $240.97	Professional	26	$86.09	$126.00	$240.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $138.85 / $149.52 / $296.12	Professional	52	$138.85	$149.52	$296.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.40 / $288.32 / $685.29	Professional	TC	$191.40	$288.32	$685.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $188.20 / $188.20 / $188.20	Professional		$188.20	$188.20	$188.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.52 / $103.22 / $138.94	Professional	26	$63.52	$103.22	$138.94
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $513.22 / $513.22 / $513.22	Professional	52	$513.22	$513.22	$513.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $180.59 / $180.59 / $180.59	Professional	TC	$180.59	$180.59	$180.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $322.38 / $407.77 / $728.59	Professional		$322.38	$407.77	$728.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.87 / $100.18 / $178.57	Professional	26	$88.87	$100.18	$178.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.03 / $293.64 / $564.30	Professional	TC	$218.03	$293.64	$564.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.34 / $185.87 / $273.20	Professional		$87.34	$185.87	$273.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.48 / $96.46 / $96.46	Facility	26	$87.48	$96.46	$96.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $262.52 / $455.13 / $908.48	Professional		$262.52	$455.13	$908.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.31 / $114.61 / $190.99	Professional	26	$73.31	$114.61	$190.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $180.40 / $317.19 / $714.43	Professional	TC	$180.40	$317.19	$714.43
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $87.48 / $87.48 / $96.46	Facility	26	$87.48	$87.48	$96.46
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $262.52 / $450.00 / $931.62	Professional		$262.52	$450.00	$931.62
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $81.87 / $119.11 / $190.99	Professional	26	$81.87	$119.11	$190.99
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $185.86 / $314.27 / $653.28	Professional	TC	$185.86	$314.27	$653.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $208.67 / $343.84	Professional		$98.87	$208.67	$343.84
United Facility/Professional Professional Modifier Low / Median / High Price $280.60 / $388.01 / $739.41	Professional		$280.60	$388.01	$739.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.40 / $99.86 / $179.08	Professional	26	$75.40	$99.86	$179.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $189.49 / $259.07 / $532.57	Professional	TC	$189.49	$259.07	$532.57