Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.86 / $84.17 / $201.29	Facility	26	$58.86	$84.17	$201.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.71 / $237.07 / $521.41	Professional		$170.71	$237.07	$521.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $61.64 / $179.40	Professional	26	$52.78	$61.64	$179.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.85 / $166.98 / $377.54	Professional	TC	$111.85	$166.98	$377.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.55 / $90.22 / $100.16	Professional	26	$43.55	$90.22	$100.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.54 / $264.08 / $487.03	Professional		$205.54	$264.08	$487.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.31 / $68.58 / $121.04	Professional	26	$61.31	$68.58	$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 $59.87 / $112.24 / $172.12	Professional		$59.87	$112.24	$172.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.91 / $66.34 / $66.34	Facility	26	$59.91	$66.34	$66.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.58 / $290.20 / $548.41	Professional		$164.58	$290.20	$548.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.43 / $77.66 / $131.71	Professional	26	$50.43	$77.66	$131.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.93 / $197.68 / $401.13	Professional	TC	$108.93	$197.68	$401.13
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $59.91 / $59.91 / $66.34	Facility	26	$59.91	$59.91	$66.34
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $164.58 / $281.64 / $560.35	Professional		$164.58	$281.64	$560.35
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $55.93 / $81.55 / $141.87	Professional	26	$55.93	$81.55	$141.87
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $112.24 / $183.88 / $375.87	Professional	TC	$112.24	$183.88	$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 $173.89 / $252.48 / $439.87	Professional		$173.89	$252.48	$439.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.61 / $69.72 / $125.38	Professional	26	$51.61	$69.72	$125.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.02 / $169.66 / $314.64	Professional	TC	$117.02	$169.66	$314.64