Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.27 / $148.77 / $352.96	Facility	26	$106.27	$148.77	$352.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $475.00 / $959.30	Professional		$375.00	$475.00	$959.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.64 / $140.00 / $239.10	Professional	26	$103.64	$140.00	$239.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $741.47	Professional	TC	$281.41	$335.00	$741.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $299.08 / $317.14 / $393.13	Professional		$299.08	$317.14	$393.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.23 / $125.50 / $163.99	Professional	26	$77.23	$125.50	$163.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.45 / $447.72 / $727.54	Professional		$338.45	$447.72	$727.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.45 / $109.26 / $201.14	Professional	26	$78.45	$109.26	$201.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.00 / $343.20 / $539.29	Professional	TC	$260.00	$343.20	$539.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.19 / $304.22 / $410.41	Professional		$106.19	$304.22	$410.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.09 / $116.52 / $116.52	Facility	26	$105.09	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $396.67 / $664.66 / $1,339.15	Professional		$396.67	$664.66	$1,339.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.57 / $137.65 / $230.45	Professional	26	$88.57	$137.65	$230.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $303.31 / $513.09 / $1,083.94	Professional	TC	$303.31	$513.09	$1,083.94
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $105.09 / $105.09 / $116.52	Facility	26	$105.09	$105.09	$116.52
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $398.29 / $652.16 / $1,426.37	Professional		$398.29	$652.16	$1,426.37
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $98.29 / $143.19 / $268.16	Professional	26	$98.29	$143.19	$268.16
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $304.22 / $481.38 / $1,012.69	Professional	TC	$304.22	$481.38	$1,012.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $313.01 / $515.91	Professional		$98.87	$313.01	$515.91
United Facility/Professional Professional Modifier Low / Median / High Price $413.66 / $599.66 / $1,083.28	Professional		$413.66	$599.66	$1,083.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.25 / $121.12 / $212.26	Professional	26	$89.25	$121.12	$212.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $317.30 / $438.23 / $845.74	Professional	TC	$317.30	$438.23	$845.74