Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.93 / $87.13 / $209.49	Facility	26	$60.93	$87.13	$209.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.85 / $235.83 / $420.29	Professional		$192.85	$235.83	$420.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $60.93 / $109.28	Professional	26	$54.56	$60.93	$109.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.87 / $168.52 / $321.70	Professional	TC	$134.87	$168.52	$321.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.08 / $71.68 / $93.39	Professional	26	$45.08	$71.68	$93.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.62 / $284.80 / $494.23	Professional		$234.62	$284.80	$494.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.74 / $70.70 / $126.00	Professional	26	$63.74	$70.70	$126.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $160.66 / $214.38 / $376.23	Professional	TC	$160.66	$214.38	$376.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.99 / $136.55 / $220.70	Professional		$61.99	$136.55	$220.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.22 / $68.70 / $68.70	Facility	26	$62.22	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $191.68 / $334.75 / $646.24	Professional		$191.68	$334.75	$646.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.21 / $80.70 / $137.13	Professional	26	$52.21	$80.70	$137.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.55 / $244.84 / $502.09	Professional	TC	$132.55	$244.84	$502.09
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $62.22 / $62.22 / $68.70	Facility	26	$62.22	$62.22	$68.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $191.68 / $324.87 / $659.77	Professional		$191.68	$324.87	$659.77
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $57.13 / $82.80 / $137.13	Professional	26	$57.13	$82.80	$137.13
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $136.55 / $223.45 / $473.39	Professional	TC	$136.55	$223.45	$473.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.46 / $162.86 / $261.30	Professional		$40.46	$162.86	$261.30
United Facility/Professional Professional Modifier Low / Median / High Price $206.37 / $284.33 / $522.45	Professional		$206.37	$284.33	$522.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.29 / $71.72 / $127.14	Professional	26	$54.29	$71.72	$127.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.19 / $222.75 / $375.60	Professional	TC	$143.19	$222.75	$375.60