Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.31 / $158.63 / $376.12	Facility	26	$113.31	$158.63	$376.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $330.58 / $475.00 / $1,078.03	Professional		$330.58	$475.00	$1,078.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.41 / $145.16 / $362.98	Professional	26	$110.41	$145.16	$362.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.27 / $335.00 / $786.09	Professional	TC	$217.27	$335.00	$786.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $168.85 / $234.72 / $293.39	Professional		$168.85	$234.72	$293.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.30 / $133.74 / $189.29	Professional	26	$82.30	$133.74	$189.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $203.93 / $203.93 / $343.76	Professional	TC	$203.93	$203.93	$343.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $381.15 / $449.97 / $784.51	Professional		$381.15	$449.97	$784.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.92 / $131.55 / $236.22	Professional	26	$117.92	$131.55	$236.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $242.25 / $315.33 / $568.71	Professional	TC	$242.25	$315.33	$568.71
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $346.51 / $346.51 / $381.75	Professional		$346.51	$346.51	$381.75
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 $225.11 / $225.11 / $248.00	Professional	TC	$225.11	$225.11	$248.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.17 / $240.66 / $419.33	Professional		$113.17	$240.66	$419.33
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 $310.04 / $544.19 / $1,230.59	Professional		$310.04	$544.19	$1,230.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.27 / $147.91 / $245.59	Professional	26	$95.27	$147.91	$245.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.92 / $360.70 / $1,020.19	Professional	TC	$204.92	$360.70	$1,020.19
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 $310.04 / $539.04 / $1,251.15	Professional		$310.04	$539.04	$1,251.15
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $107.76 / $163.30 / $293.87	Professional	26	$107.76	$163.30	$293.87
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $209.85 / $350.00 / $977.77	Professional	TC	$209.85	$350.00	$977.77
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 $306.08 / $448.17 / $997.05	Professional		$306.08	$448.17	$997.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.61 / $126.67 / $230.36	Professional	26	$95.61	$126.67	$230.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.47 / $300.55 / $784.14	Professional	TC	$217.47	$300.55	$784.14