Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.87 / $91.53 / $227.93	Facility	26	$59.87	$91.53	$227.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.77 / $284.69 / $465.46	Professional		$195.77	$284.69	$465.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.44 / $69.23 / $190.50	Professional	26	$57.44	$69.23	$190.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.68 / $214.95 / $375.54	Professional	TC	$136.68	$214.95	$375.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.91 / $147.75 / $164.08	Professional		$115.91	$147.75	$164.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.84 / $55.97 / $94.73	Professional	26	$43.84	$55.97	$94.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.79 / $290.64 / $504.36	Professional		$233.79	$290.64	$504.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.56 / $75.91 / $135.32	Professional	26	$65.56	$75.91	$135.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $159.75 / $212.80 / $376.23	Professional	TC	$159.75	$212.80	$376.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.27 / $156.59 / $259.89	Professional		$61.27	$156.59	$259.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $67.81	Facility	26	$67.54	$67.54	$67.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.15 / $331.90 / $648.75	Professional		$190.15	$331.90	$648.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.19 / $81.34 / $137.81	Professional	26	$54.19	$81.34	$137.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.55 / $238.39 / $473.86	Professional	TC	$132.55	$238.39	$473.86
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $67.81	Facility	26	$67.54	$67.54	$67.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $197.82 / $323.70 / $658.29	Professional		$197.82	$323.70	$658.29
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $58.48 / $86.58 / $150.88	Professional	26	$58.48	$86.58	$150.88
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $136.55 / $223.15 / $460.18	Professional	TC	$136.55	$223.15	$460.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $161.71 / $261.30	Professional		$40.55	$161.71	$261.30
United Facility/Professional Professional Modifier Low / Median / High Price $207.94 / $287.75 / $530.89	Professional		$207.94	$287.75	$530.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.02 / $77.20 / $140.74	Professional	26	$57.02	$77.20	$140.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.66 / $194.41 / $380.67	Professional	TC	$140.66	$194.41	$380.67