Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.28 / $124.81 / $299.66	Facility	26	$87.28	$124.81	$299.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.93 / $374.41 / $732.75	Professional		$251.93	$374.41	$732.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.31 / $97.62 / $289.08	Professional	26	$81.31	$97.62	$289.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $170.48 / $268.45 / $565.84	Professional	TC	$170.48	$268.45	$565.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $212.61 / $220.05 / $280.43	Professional		$212.61	$220.05	$280.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.86 / $95.79 / $149.71	Professional	26	$63.86	$95.79	$149.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $156.34 / $156.34 / $156.34	Professional	TC	$156.34	$156.34	$156.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.06 / $333.90 / $579.09	Professional		$251.06	$333.90	$579.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.06 / $97.06 / $189.48	Professional	26	$61.06	$97.06	$189.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $231.80 / $379.14	Professional	TC	$190.00	$231.80	$379.14
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $305.48 / $473.75 / $473.75	Professional		$305.48	$473.75	$473.75
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $96.02 / $148.91 / $148.91	Professional	26	$96.02	$148.91	$148.91
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $209.46 / $324.83 / $324.83	Professional	TC	$209.46	$324.83	$324.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.51 / $223.89 / $362.43	Professional		$89.51	$223.89	$362.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.24 / $98.41 / $98.41	Facility	26	$89.24	$98.41	$98.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.52 / $426.81 / $860.03	Professional		$270.52	$426.81	$860.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.70 / $115.24 / $194.80	Professional	26	$76.70	$115.24	$194.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.78 / $298.80 / $609.75	Professional	TC	$184.78	$298.80	$609.75
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $89.24 / $89.24 / $98.41	Facility	26	$89.24	$89.24	$98.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $256.66 / $394.74 / $819.59	Professional		$256.66	$394.74	$819.59
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $85.43 / $134.10 / $273.62	Professional	26	$85.43	$134.10	$273.62
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $186.39 / $288.58 / $609.75	Professional	TC	$186.39	$288.58	$609.75
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 $268.95 / $369.81 / $667.33	Professional		$268.95	$369.81	$667.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.86 / $105.55 / $187.00	Professional	26	$77.86	$105.55	$187.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.65 / $273.72 / $481.94	Professional	TC	$183.65	$273.72	$481.94