Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.39 / $150.26 / $294.02	Facility	26	$88.39	$150.26	$294.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $343.70 / $475.00 / $846.31	Professional		$343.70	$475.00	$846.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.51 / $140.00 / $260.39	Professional	26	$86.51	$140.00	$260.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $255.30 / $335.00 / $688.70	Professional	TC	$255.30	$335.00	$688.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $631.91 / $631.91 / $631.91	Professional		$631.91	$631.91	$631.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.83 / $111.69 / $139.62	Professional	26	$63.83	$111.69	$139.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $374.28 / $423.40 / $733.76	Professional		$374.28	$423.40	$733.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.28 / $101.03 / $179.50	Professional	26	$89.28	$101.03	$179.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $275.52 / $325.47 / $564.30	Professional	TC	$275.52	$325.47	$564.30
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $556.66 / $556.66 / $556.66	Professional		$556.66	$556.66	$556.66
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $146.00 / $146.00 / $146.00	Professional	26	$146.00	$146.00	$146.00
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $410.67 / $410.67 / $410.67	Professional	TC	$410.67	$410.67	$410.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.76 / $246.85 / $380.24	Professional		$87.76	$246.85	$380.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.72 / $96.95 / $96.95	Facility	26	$87.72	$96.95	$96.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.42 / $525.00 / $983.12	Professional		$323.42	$525.00	$983.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.66 / $115.69 / $192.61	Professional	26	$73.66	$115.69	$192.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.72 / $402.64 / $751.93	Professional	TC	$239.72	$402.64	$751.93
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $87.72 / $87.72 / $96.95	Facility	26	$87.72	$87.72	$96.95
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $324.24 / $515.00 / $943.28	Professional		$324.24	$515.00	$943.28
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $82.43 / $119.93 / $210.00	Professional	26	$82.43	$119.93	$210.00
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $246.85 / $367.50 / $729.32	Professional	TC	$246.85	$367.50	$729.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.04 / $262.44 / $431.39	Professional		$96.04	$262.44	$431.39
United Facility/Professional Professional Modifier Low / Median / High Price $335.34 / $448.65 / $775.18	Professional		$335.34	$448.65	$775.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.95 / $100.26 / $183.34	Professional	26	$75.95	$100.26	$183.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.33 / $337.85 / $614.89	Professional	TC	$243.33	$337.85	$614.89