Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.48 / $103.66 / $240.62	Facility	26	$72.48	$103.66	$240.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.66 / $405.87 / $841.25	Professional		$236.66	$405.87	$841.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.48 / $124.32 / $240.62	Professional	26	$70.48	$124.32	$240.62
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $118.33 / $126.45 / $262.50	Professional	52	$118.33	$126.45	$262.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $164.17 / $281.55 / $557.00	Professional	TC	$164.17	$281.55	$557.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.47 / $177.70 / $209.39	Professional		$158.47	$177.70	$209.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.15 / $82.21 / $119.94	Professional	26	$52.15	$82.21	$119.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.69 / $162.69 / $162.69	Professional	TC	$162.69	$162.69	$162.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.77 / $376.30 / $715.36	Professional		$271.77	$376.30	$715.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.87 / $78.34 / $148.51	Professional	26	$53.87	$78.34	$148.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $201.81 / $291.24 / $544.96	Professional	TC	$201.81	$291.24	$544.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.70 / $181.58 / $302.08	Professional		$71.70	$181.58	$302.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.67 / $79.45 / $79.45	Facility	26	$71.67	$79.45	$79.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.12 / $406.49 / $811.14	Professional		$222.12	$406.49	$811.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.40 / $93.26 / $157.54	Professional	26	$60.40	$93.26	$157.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $157.78 / $318.47 / $647.83	Professional	TC	$157.78	$318.47	$647.83
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $71.67 / $71.67 / $79.45	Facility	26	$71.67	$71.67	$79.45
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $222.55 / $403.01 / $777.14	Professional		$222.55	$403.01	$777.14
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $68.44 / $96.62 / $163.47	Professional	26	$68.44	$96.62	$163.47
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $158.27 / $280.00 / $574.91	Professional	TC	$158.27	$280.00	$574.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.62 / $165.66 / $267.81	Professional		$65.62	$165.66	$267.81
United Facility/Professional Professional Modifier Low / Median / High Price $234.59 / $346.41 / $675.83	Professional		$234.59	$346.41	$675.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.30 / $82.29 / $153.91	Professional	26	$60.30	$82.29	$153.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $166.49 / $234.29 / $510.44	Professional	TC	$166.49	$234.29	$510.44