Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.77 / $79.75 / $192.04	Facility	26	$55.77	$79.75	$192.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.27 / $230.60 / $496.00	Professional		$192.27	$230.60	$496.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.15 / $58.83 / $123.01	Professional	26	$51.15	$58.83	$123.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.15 / $171.77 / $364.76	Professional	TC	$144.15	$171.77	$364.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.47 / $158.47 / $379.16	Professional		$158.47	$158.47	$379.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.26 / $53.63 / $349.30	Professional	26	$41.26	$53.63	$349.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.79 / $255.71 / $443.76	Professional		$227.79	$255.71	$443.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.79 / $64.89 / $115.95	Professional	26	$57.79	$64.89	$115.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $161.09 / $191.56 / $334.42	Professional	TC	$161.09	$191.56	$334.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $144.33 / $201.06	Professional		$56.73	$144.33	$201.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.09 / $62.89 / $62.89	Facility	26	$57.09	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.60 / $295.79 / $537.07	Professional		$193.60	$295.79	$537.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.80 / $74.17 / $123.23	Professional	26	$47.80	$74.17	$123.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.10 / $217.93 / $413.97	Professional	TC	$140.10	$217.93	$413.97
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $57.09 / $57.09 / $62.89	Facility	26	$57.09	$57.09	$62.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $194.55 / $292.45 / $537.04	Professional		$194.55	$292.45	$537.04
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $53.32 / $77.34 / $127.68	Professional	26	$53.32	$77.34	$127.68
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $143.44 / $212.56 / $401.08	Professional	TC	$143.44	$212.56	$401.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $161.71 / $261.30	Professional		$40.54	$161.71	$261.30
United Facility/Professional Professional Modifier Low / Median / High Price $195.79 / $267.44 / $488.27	Professional		$195.79	$267.44	$488.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.24 / $65.48 / $118.38	Professional	26	$48.24	$65.48	$118.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.90 / $183.25 / $333.48	Professional	TC	$141.90	$183.25	$333.48