Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.16 / $103.19 / $239.54	Facility	26	$72.16	$103.19	$239.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.35 / $425.00 / $700.00	Professional		$293.35	$425.00	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.67 / $120.99 / $240.02	Professional	26	$70.67	$120.99	$240.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $222.87 / $330.92 / $558.79	Professional	TC	$222.87	$330.92	$558.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $322.16 / $349.59 / $349.59	Professional		$322.16	$349.59	$349.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.15 / $52.15 / $54.67	Professional	26	$52.15	$52.15	$54.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $358.11 / $401.08 / $704.23	Professional		$358.11	$401.08	$704.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.39 / $83.02 / $147.33	Professional	26	$70.39	$83.02	$147.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $265.49 / $319.20 / $564.30	Professional	TC	$265.49	$319.20	$564.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.70 / $263.66 / $343.23	Professional		$71.70	$263.66	$343.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.34 / $79.09 / $79.09	Facility	26	$71.34	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $324.44 / $503.04 / $970.91	Professional		$324.44	$503.04	$970.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.12 / $93.26 / $156.83	Professional	26	$60.12	$93.26	$156.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $262.50 / $409.63 / $790.30	Professional	TC	$262.50	$409.63	$790.30
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $71.34 / $71.34 / $79.09	Facility	26	$71.34	$71.34	$79.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $328.38 / $500.00 / $948.89	Professional		$328.38	$500.00	$948.89
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $66.65 / $96.62 / $150.00	Professional	26	$66.65	$96.62	$150.00
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $263.93 / $392.14 / $732.91	Professional	TC	$263.93	$392.14	$732.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.67 / $238.83 / $390.28	Professional		$65.67	$238.83	$390.28
United Facility/Professional Professional Modifier Low / Median / High Price $347.27 / $453.92 / $822.76	Professional		$347.27	$453.92	$822.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.45 / $78.77 / $143.87	Professional	26	$61.45	$78.77	$143.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $285.08 / $362.64 / $655.38	Professional	TC	$285.08	$362.64	$655.38