Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.50 / $84.69 / $201.29	Facility	26	$58.50	$84.69	$201.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.71 / $236.33 / $555.86	Professional		$169.71	$236.33	$555.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.93 / $62.84 / $202.42	Professional	26	$52.93	$62.84	$202.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.21 / $174.75 / $450.20	Professional	TC	$111.21	$174.75	$450.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.12 / $128.12 / $128.12	Professional		$128.12	$128.12	$128.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.28 / $75.73 / $99.54	Professional	26	$43.28	$75.73	$99.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.39 / $264.08 / $485.43	Professional		$204.39	$264.08	$485.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.57 / $67.67 / $122.76	Professional	26	$60.57	$67.67	$122.76
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 / $127.89 / $223.09	Professional		$59.51	$127.89	$223.09
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 $163.68 / $288.07 / $535.62	Professional		$163.68	$288.07	$535.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.15 / $77.80 / $131.00	Professional	26	$50.15	$77.80	$131.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.31 / $197.10 / $400.05	Professional	TC	$108.31	$197.10	$400.05
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 $163.68 / $279.98 / $535.62	Professional		$163.68	$279.98	$535.62
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $55.59 / $81.55 / $151.47	Professional	26	$55.59	$81.55	$151.47
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $111.59 / $185.81 / $375.39	Professional	TC	$111.59	$185.81	$375.39
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 $178.97 / $239.05 / $437.47	Professional		$178.97	$239.05	$437.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.52 / $69.11 / $124.88	Professional	26	$49.52	$69.11	$124.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.25 / $176.19 / $309.74	Professional	TC	$119.25	$176.19	$309.74