Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.98 / $131.33 / $296.41	Facility	26	$85.98	$131.33	$296.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $244.23 / $315.49 / $542.92	Professional		$244.23	$315.49	$542.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.34 / $87.04 / $181.00	Professional	26	$78.34	$87.04	$181.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.16 / $212.72 / $385.85	Professional	TC	$163.16	$212.72	$385.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $189.64 / $189.64 / $189.64	Professional		$189.64	$189.64	$189.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.84 / $337.76 / $567.37	Professional		$250.84	$337.76	$567.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.84 / $91.47 / $182.52	Professional	26	$60.84	$91.47	$182.52
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $231.80 / $379.14	Professional	TC	$190.00	$231.80	$379.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.18 / $218.60 / $306.77	Professional		$88.18	$218.60	$306.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.10 / $96.97 / $96.97	Facility	26	$88.10	$96.97	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.57 / $445.24 / $885.45	Professional		$287.57	$445.24	$885.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.66 / $112.59 / $191.91	Professional	26	$73.66	$112.59	$191.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.10 / $317.97 / $648.94	Professional	TC	$203.10	$317.97	$648.94
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $88.10 / $88.10 / $96.97	Facility	26	$88.10	$88.10	$96.97
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $287.57 / $435.53 / $870.10	Professional		$287.57	$435.53	$870.10
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $80.65 / $115.86 / $204.93	Professional	26	$80.65	$115.86	$204.93
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $203.10 / $309.43 / $645.87	Professional	TC	$203.10	$309.43	$645.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $180.48 / $337.88	Professional		$98.87	$180.48	$337.88
United Facility/Professional Professional Modifier Low / Median / High Price $282.63 / $393.11 / $709.37	Professional		$282.63	$393.11	$709.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.81 / $101.71 / $181.30	Professional	26	$76.81	$101.71	$181.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.66 / $275.04 / $501.00	Professional	TC	$198.66	$275.04	$501.00