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 $331.89 / $475.00 / $1,098.08	Professional		$331.89	$475.00	$1,098.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.41 / $145.16 / $381.25	Professional	26	$110.41	$145.16	$381.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.58 / $335.00 / $791.50	Professional	TC	$218.58	$335.00	$791.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.45 / $255.37 / $339.05	Professional		$223.45	$255.37	$339.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.17 / $123.01 / $174.72	Professional	26	$81.17	$123.01	$174.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $382.68 / $455.44 / $804.72	Professional		$382.68	$455.44	$804.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.68 / $139.21 / $251.25	Professional	26	$120.68	$139.21	$251.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $242.25 / $316.70 / $564.30	Professional	TC	$242.25	$316.70	$564.30
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $383.28 / $383.28 / $539.54	Professional		$383.28	$383.28	$539.54
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $133.74 / $133.74 / $188.27	Professional	26	$133.74	$133.74	$188.27
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $249.54 / $249.54 / $351.27	Professional	TC	$249.54	$249.54	$351.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.17 / $242.16 / $421.91	Professional		$113.17	$242.16	$421.91
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 $310.58 / $530.69 / $1,207.27	Professional		$310.58	$530.69	$1,207.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.95 / $147.91 / $249.47	Professional	26	$98.95	$147.91	$249.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $205.60 / $363.48 / $994.34	Professional	TC	$205.60	$363.48	$994.34
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 $309.57 / $524.49 / $1,314.44	Professional		$309.57	$524.49	$1,314.44
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $107.99 / $164.84 / $289.47	Professional	26	$107.99	$164.84	$289.47
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $211.15 / $345.52 / $926.94	Professional	TC	$211.15	$345.52	$926.94
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 $325.52 / $486.53 / $988.85	Professional		$325.52	$486.53	$988.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.70 / $133.91 / $229.70	Professional	26	$99.70	$133.91	$229.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.92 / $302.24 / $772.01	Professional	TC	$218.92	$302.24	$772.01