Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.18 / $96.07 / $223.27	Facility	26	$67.18	$96.07	$223.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $271.64 / $425.00 / $700.00	Professional		$271.64	$425.00	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.18 / $115.21 / $178.31	Professional	26	$67.18	$115.21	$178.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $233.65 / $335.00 / $558.41	Professional	TC	$233.65	$335.00	$558.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $180.00 / $227.33 / $504.92	Professional		$180.00	$227.33	$504.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.33 / $51.35 / $105.72	Professional	26	$48.33	$51.35	$105.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $308.26 / $373.82 / $653.94	Professional		$308.26	$373.82	$653.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.26 / $71.58 / $135.49	Professional	26	$48.26	$71.58	$135.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $249.20 / $299.00 / $518.83	Professional	TC	$249.20	$299.00	$518.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $265.33 / $394.20	Professional		$66.45	$265.33	$394.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.40 / $73.64 / $73.64	Facility	26	$66.40	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $291.74 / $475.64 / $907.97	Professional		$291.74	$475.64	$907.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.99 / $86.37 / $147.47	Professional	26	$55.99	$86.37	$147.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.55 / $384.77 / $726.34	Professional	TC	$231.55	$384.77	$726.34
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $66.40 / $66.40 / $73.64	Facility	26	$66.40	$66.40	$73.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $295.00 / $475.64 / $840.77	Professional		$295.00	$475.64	$840.77
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $90.56 / $167.27	Professional	26	$61.68	$90.56	$167.27
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $235.13 / $350.00 / $707.78	Professional	TC	$235.13	$350.00	$707.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.67 / $238.83 / $390.28	Professional		$65.67	$238.83	$390.28
United Facility/Professional Professional Modifier Low / Median / High Price $311.89 / $423.20 / $716.74	Professional		$311.89	$423.20	$716.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.93 / $74.61 / $136.24	Professional	26	$53.93	$74.61	$136.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.71 / $325.47 / $595.33	Professional	TC	$245.71	$325.47	$595.33