Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.50 / $103.10 / $201.29	Facility	26	$58.50	$103.10	$201.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.39 / $236.70 / $555.86	Professional		$169.39	$236.70	$555.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $62.12 / $161.82	Professional	26	$52.46	$62.12	$161.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $110.89 / $165.56 / $450.78	Professional	TC	$110.89	$165.56	$450.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.28 / $70.33 / $94.68	Professional	26	$43.28	$70.33	$94.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.97 / $264.08 / $485.43	Professional		$203.97	$264.08	$485.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.95 / $67.83 / $121.04	Professional	26	$60.95	$67.83	$121.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.27 / $193.80 / $376.23	Professional	TC	$137.27	$193.80	$376.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.51 / $110.95 / $170.46	Professional		$59.51	$110.95	$170.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.91 / $65.98 / $65.98	Facility	26	$59.91	$65.98	$65.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.36 / $288.07 / $544.41	Professional		$163.36	$288.07	$544.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.15 / $77.26 / $131.00	Professional	26	$50.15	$77.26	$131.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.68 / $197.68 / $400.59	Professional	TC	$107.68	$197.68	$400.59
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $59.91 / $59.91 / $65.98	Facility	26	$59.91	$59.91	$65.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $163.36 / $283.13 / $556.90	Professional		$163.36	$283.13	$556.90
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $54.85 / $79.53 / $141.41	Professional	26	$54.85	$79.53	$141.41
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $110.94 / $181.95 / $375.87	Professional	TC	$110.94	$181.95	$375.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $127.68 / $219.02	Professional		$40.55	$127.68	$219.02
United Facility/Professional Professional Modifier Low / Median / High Price $172.67 / $242.00 / $436.68	Professional		$172.67	$242.00	$436.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.61 / $69.19 / $125.38	Professional	26	$51.61	$69.19	$125.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.90 / $171.12 / $317.35	Professional	TC	$115.90	$171.12	$317.35