Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.19 / $146.36 / $285.75	Facility	26	$85.19	$146.36	$285.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $277.24 / $370.50 / $587.75	Professional		$277.24	$370.50	$587.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.67 / $111.15 / $155.65	Professional	26	$83.67	$111.15	$155.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.05 / $259.35 / $393.48	Professional	TC	$192.05	$259.35	$393.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.52 / $61.52 / $62.89	Professional	26	$61.52	$61.52	$62.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.02 / $417.17 / $723.95	Professional		$320.02	$417.17	$723.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.17 / $96.01 / $169.81	Professional	26	$80.17	$96.01	$169.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $220.03 / $319.20 / $564.30	Professional	TC	$220.03	$319.20	$564.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.59 / $186.19 / $301.63	Professional		$84.59	$186.19	$301.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.02 / $93.41 / $93.41	Facility	26	$85.02	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.63 / $465.00 / $913.35	Professional		$260.63	$465.00	$913.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.98 / $110.95 / $185.70	Professional	26	$70.98	$110.95	$185.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $184.52 / $355.45 / $718.16	Professional	TC	$184.52	$355.45	$718.16
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $85.02 / $85.02 / $93.41	Facility	26	$85.02	$85.02	$93.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $270.77 / $457.51 / $935.28	Professional		$270.77	$457.51	$935.28
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $77.66 / $112.12 / $183.99	Professional	26	$77.66	$112.12	$183.99
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $186.19 / $324.56 / $663.38	Professional	TC	$186.19	$324.56	$663.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $209.12 / $343.84	Professional		$98.87	$209.12	$343.84
United Facility/Professional Professional Modifier Low / Median / High Price $273.77 / $424.54 / $736.13	Professional		$273.77	$424.54	$736.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.05 / $95.68 / $174.18	Professional	26	$67.05	$95.68	$174.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.17 / $277.45 / $576.79	Professional	TC	$193.17	$277.45	$576.79