Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.31 / $162.03 / $376.12	Facility	26	$113.31	$162.03	$376.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.24 / $475.00 / $1,096.38	Professional		$331.24	$475.00	$1,096.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.76 / $153.94 / $423.94	Professional	26	$110.76	$153.94	$423.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.93 / $335.00 / $788.25	Professional	TC	$217.93	$335.00	$788.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.00 / $254.85 / $308.39	Professional		$223.00	$254.85	$308.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.17 / $133.74 / $180.04	Professional	26	$81.17	$133.74	$180.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $184.14 / $184.14 / $184.14	Professional	TC	$184.14	$184.14	$184.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $381.92 / $459.01 / $805.46	Professional		$381.92	$459.01	$805.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.68 / $139.33 / $253.74	Professional	26	$120.68	$139.33	$253.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $242.25 / $315.74 / $564.30	Professional	TC	$242.25	$315.74	$564.30
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $347.20 / $347.20 / $382.51	Professional		$347.20	$347.20	$382.51
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $121.40 / $121.40 / $133.74	Professional	26	$121.40	$121.40	$133.74
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $225.80 / $225.80 / $248.77	Professional	TC	$225.80	$225.80	$248.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.17 / $241.41 / $420.63	Professional		$113.17	$241.41	$420.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.95 / $124.22 / $124.22	Facility	26	$111.95	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.67 / $545.25 / $1,250.80	Professional		$310.67	$545.25	$1,250.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.26 / $149.16 / $248.92	Professional	26	$101.26	$149.16	$248.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $205.53 / $363.01 / $1,022.51	Professional	TC	$205.53	$363.01	$1,022.51
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $111.95 / $111.95 / $124.22	Facility	26	$111.95	$111.95	$124.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $310.67 / $524.03 / $1,263.00	Professional		$310.67	$524.03	$1,263.00
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $107.99 / $164.60 / $295.83	Professional	26	$107.99	$164.60	$295.83
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $210.50 / $350.00 / $978.25	Professional	TC	$210.50	$350.00	$978.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $99.93 / $212.75 / $381.71	Professional		$99.93	$212.75	$381.71
United Facility/Professional Professional Modifier Low / Median / High Price $333.69 / $449.02 / $1,009.06	Professional		$333.69	$449.02	$1,009.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $101.93 / $132.76 / $229.70	Professional	26	$101.93	$132.76	$229.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.31 / $298.58 / $785.08	Professional	TC	$218.31	$298.58	$785.08