Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.60 / $176.40 / $354.04	Facility	26	$106.60	$176.40	$354.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.50 / $475.00 / $1,054.05	Professional		$370.50	$475.00	$1,054.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.59 / $140.00 / $264.06	Professional	26	$106.59	$140.00	$264.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $280.51 / $335.00 / $868.71	Professional	TC	$280.51	$335.00	$868.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $267.11 / $299.39 / $370.14	Professional		$267.11	$299.39	$370.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.16 / $135.16 / $489.30	Professional	26	$79.16	$135.16	$489.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.52 / $456.31 / $750.00	Professional		$337.52	$456.31	$750.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.52 / $113.88 / $218.78	Professional	26	$77.52	$113.88	$218.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.00 / $334.11 / $537.47	Professional	TC	$260.00	$334.11	$537.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.19 / $280.51 / $434.65	Professional		$106.19	$280.51	$434.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.41 / $116.87 / $116.87	Facility	26	$105.41	$116.87	$116.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.69 / $636.92 / $1,281.76	Professional		$373.69	$636.92	$1,281.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.84 / $138.01 / $230.45	Professional	26	$88.84	$138.01	$230.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $280.00 / $477.86 / $1,024.36	Professional	TC	$280.00	$477.86	$1,024.36
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $105.41 / $105.41 / $116.87	Facility	26	$105.41	$105.41	$116.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $376.24 / $632.79 / $1,350.31	Professional		$376.24	$632.79	$1,350.31
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $98.29 / $144.18 / $268.16	Professional	26	$98.29	$144.18	$268.16
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $280.94 / $453.06 / $962.13	Professional	TC	$280.94	$453.06	$962.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $301.10 / $487.50	Professional		$98.87	$301.10	$487.50
United Facility/Professional Professional Modifier Low / Median / High Price $399.45 / $550.87 / $1,049.04	Professional		$399.45	$550.87	$1,049.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.75 / $118.16 / $211.85	Professional	26	$87.75	$118.16	$211.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $308.54 / $410.88 / $821.93	Professional	TC	$308.54	$410.88	$821.93