Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.39 / $155.00 / $362.21	Facility	26	$108.39	$155.00	$362.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.94 / $475.00 / $1,064.27	Professional		$347.94	$475.00	$1,064.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.39 / $143.00 / $373.63	Professional	26	$108.39	$143.00	$373.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.54 / $335.00 / $869.28	Professional	TC	$239.54	$335.00	$869.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.00 / $262.37 / $308.82	Professional		$199.00	$262.37	$308.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $78.76 / $135.97 / $172.29	Professional	26	$78.76	$135.97	$172.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $202.30 / $202.30 / $202.30	Professional	TC	$202.30	$202.30	$202.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $368.70 / $473.82 / $802.25	Professional		$368.70	$473.82	$802.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.70 / $120.93 / $227.16	Professional	26	$83.70	$120.93	$227.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $262.77 / $342.00 / $568.71	Professional	TC	$262.77	$342.00	$568.71
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $364.23 / $364.23 / $401.27	Professional		$364.23	$364.23	$401.27
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $116.17 / $116.17 / $127.99	Professional	26	$116.17	$116.17	$127.99
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $248.06 / $248.06 / $273.29	Professional	TC	$248.06	$248.06	$273.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.30 / $265.27 / $446.43	Professional		$108.30	$265.27	$446.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.73 / $118.86 / $118.86	Facility	26	$107.73	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.08 / $596.19 / $1,251.85	Professional		$327.08	$596.19	$1,251.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.34 / $141.33 / $235.04	Professional	26	$90.34	$141.33	$235.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $230.21 / $441.47 / $1,045.65	Professional	TC	$230.21	$441.47	$1,045.65
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $107.73 / $107.73 / $118.86	Facility	26	$107.73	$107.73	$118.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $323.00 / $565.49 / $1,212.98	Professional		$323.00	$565.49	$1,212.98
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $102.98 / $155.15 / $301.10	Professional	26	$102.98	$155.15	$301.10
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $231.25 / $406.66 / $974.32	Professional	TC	$231.25	$406.66	$974.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $247.52 / $425.35	Professional		$98.87	$247.52	$425.35
United Facility/Professional Professional Modifier Low / Median / High Price $344.20 / $492.06 / $1,028.64	Professional		$344.20	$492.06	$1,028.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.64 / $118.31 / $221.05	Professional	26	$94.64	$118.31	$221.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $252.00 / $341.68 / $826.81	Professional	TC	$252.00	$341.68	$826.81