Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.03 / $150.04 / $292.94	Facility	26	$88.03	$150.04	$292.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.69 / $432.28 / $844.56	Professional		$347.69	$432.28	$844.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.16 / $118.59 / $179.92	Professional	26	$86.16	$118.59	$179.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $322.95 / $557.00	Professional	TC	$259.35	$322.95	$557.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.40 / $64.40 / $64.40	Professional	26	$64.40	$64.40	$64.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $372.35 / $434.91 / $753.84	Professional		$372.35	$434.91	$753.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.78 / $101.24 / $182.57	Professional	26	$84.78	$101.24	$182.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $279.77 / $329.47 / $564.30	Professional	TC	$279.77	$329.47	$564.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.14 / $252.03 / $377.34	Professional		$88.14	$252.03	$377.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.22 / $96.55 / $96.55	Facility	26	$87.22	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.64 / $525.05 / $987.98	Professional		$325.64	$525.05	$987.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.36 / $114.15 / $191.43	Professional	26	$73.36	$114.15	$191.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $244.63 / $406.15 / $765.20	Professional	TC	$244.63	$406.15	$765.20
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $87.22 / $87.22 / $96.55	Facility	26	$87.22	$87.22	$96.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $328.34 / $510.26 / $951.86	Professional		$328.34	$510.26	$951.86
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $80.28 / $115.39 / $191.13	Professional	26	$80.28	$115.39	$191.13
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $252.03 / $378.05 / $733.07	Professional	TC	$252.03	$378.05	$733.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $270.54 / $436.79	Professional		$98.87	$270.54	$436.79
United Facility/Professional Professional Modifier Low / Median / High Price $349.24 / $455.82 / $783.86	Professional		$349.24	$455.82	$783.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.04 / $98.09 / $179.20	Professional	26	$70.04	$98.09	$179.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $255.83 / $350.78 / $601.03	Professional	TC	$255.83	$350.78	$601.03