Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.58 / $159.56 / $371.49	Facility	26	$111.58	$159.56	$371.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $478.24 / $1,060.52	Professional		$400.00	$478.24	$1,060.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.15 / $140.00 / $352.03	Professional	26	$111.15	$140.00	$352.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $366.66 / $864.37	Professional	TC	$281.41	$366.66	$864.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $247.06 / $372.04 / $888.85	Professional		$247.06	$372.04	$888.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $88.37 / $131.72 / $177.31	Professional	26	$88.37	$131.72	$177.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $368.00 / $518.49 / $821.80	Professional		$368.00	$518.49	$821.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.00 / $116.51 / $227.16	Professional	26	$83.00	$116.51	$227.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $285.00 / $384.32 / $590.16	Professional	TC	$285.00	$384.32	$590.16
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $555.98 / $555.98 / $555.98	Professional		$555.98	$555.98	$555.98
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $131.72 / $131.72 / $131.72	Professional	26	$131.72	$131.72	$131.72
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $424.27 / $424.27 / $424.27	Professional	TC	$424.27	$424.27	$424.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $111.45 / $359.00 / $534.60	Professional		$111.45	$359.00	$534.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.54 / $122.33 / $122.33	Facility	26	$110.54	$122.33	$122.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $454.88 / $769.83 / $1,487.15	Professional		$454.88	$769.83	$1,487.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.97 / $144.28 / $241.11	Professional	26	$92.97	$144.28	$241.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $350.00 / $599.98 / $1,218.34	Professional	TC	$350.00	$599.98	$1,218.34
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $110.54 / $110.54 / $122.33	Facility	26	$110.54	$110.54	$122.33
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $458.09 / $705.67 / $1,600.52	Professional		$458.09	$705.67	$1,600.52
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $103.21 / $150.00 / $276.12	Professional	26	$103.21	$150.00	$276.12
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $359.00 / $540.99 / $1,157.90	Professional	TC	$359.00	$540.99	$1,157.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $99.93 / $373.33 / $607.28	Professional		$99.93	$373.33	$607.28
United Facility/Professional Professional Modifier Low / Median / High Price $485.35 / $664.51 / $1,222.05	Professional		$485.35	$664.51	$1,222.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.15 / $124.78 / $222.91	Professional	26	$94.15	$124.78	$222.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $380.86 / $537.02 / $965.78	Professional	TC	$380.86	$537.02	$965.78