Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.18 / $83.20 / $200.21	Facility	26	$58.18	$83.20	$200.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.15 / $269.83 / $655.42	Professional		$222.15	$269.83	$655.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $61.24 / $154.79	Professional	26	$52.46	$61.24	$154.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.55 / $208.25 / $420.28	Professional	TC	$164.55	$208.25	$420.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.44 / $198.25 / $211.29	Professional		$147.44	$198.25	$211.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.70 / $43.54 / $75.73	Professional	26	$42.70	$43.54	$75.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.59 / $288.22 / $501.90	Professional		$250.59	$288.22	$501.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.59 / $67.67 / $120.57	Professional	26	$60.59	$67.67	$120.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $221.49 / $379.14	Professional	TC	$190.00	$221.49	$379.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.51 / $191.65 / $252.90	Professional		$59.51	$191.65	$252.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.58 / $65.64 / $65.64	Facility	26	$59.58	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.75 / $365.33 / $685.96	Professional		$239.75	$365.33	$685.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.88 / $77.80 / $131.00	Professional	26	$49.88	$77.80	$131.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $182.94 / $279.69 / $544.90	Professional	TC	$182.94	$279.69	$544.90
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $59.58 / $59.58 / $65.64	Facility	26	$59.58	$59.58	$65.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $239.75 / $365.33 / $687.51	Professional		$239.75	$365.33	$687.51
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $54.57 / $78.44 / $131.00	Professional	26	$54.57	$78.44	$131.00
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $184.16 / $276.79 / $544.90	Professional	TC	$184.16	$276.79	$544.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $196.97 / $313.88	Professional		$40.55	$196.97	$313.88
United Facility/Professional Professional Modifier Low / Median / High Price $239.45 / $322.95 / $552.90	Professional		$239.45	$322.95	$552.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.34 / $69.19 / $135.53	Professional	26	$51.34	$69.19	$135.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.84 / $242.87 / $433.43	Professional	TC	$180.84	$242.87	$433.43