Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.94 / $151.49 / $352.96	Facility	26	$105.94	$151.49	$352.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.12 / $434.12 / $1,054.05	Professional		$339.12	$434.12	$1,054.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.64 / $140.00 / $322.06	Professional	26	$103.64	$140.00	$322.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.16 / $318.52 / $783.89	Professional	TC	$242.16	$318.52	$783.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $234.34 / $256.76 / $324.41	Professional		$234.34	$256.76	$324.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.23 / $113.63 / $168.95	Professional	26	$77.23	$113.63	$168.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $240.02 / $240.02 / $240.02	Professional	TC	$240.02	$240.02	$240.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.84 / $427.17 / $710.72	Professional		$337.84	$427.17	$710.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.84 / $108.65 / $200.26	Professional	26	$77.84	$108.65	$200.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.00 / $314.60 / $518.83	Professional	TC	$260.00	$314.60	$518.83
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $364.41 / $364.41 / $364.41	Professional		$364.41	$364.41	$364.41
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $113.92 / $113.92 / $113.92	Professional	26	$113.92	$113.92	$113.92
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $250.50 / $250.50 / $250.50	Professional	TC	$250.50	$250.50	$250.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.19 / $267.88 / $446.52	Professional		$106.19	$267.88	$446.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.09 / $116.17 / $116.17	Facility	26	$105.09	$116.17	$116.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.39 / $574.75 / $1,227.91	Professional		$327.39	$574.75	$1,227.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.29 / $136.25 / $230.46	Professional	26	$88.29	$136.25	$230.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.83 / $445.80 / $1,041.68	Professional	TC	$228.83	$445.80	$1,041.68
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $105.09 / $105.09 / $116.17	Facility	26	$105.09	$105.09	$116.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $327.39 / $567.65 / $1,347.69	Professional		$327.39	$567.65	$1,347.69
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $96.58 / $144.81 / $267.32	Professional	26	$96.58	$144.81	$267.32
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $233.51 / $399.94 / $984.98	Professional	TC	$233.51	$399.94	$984.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $247.52 / $425.35	Professional		$98.87	$247.52	$425.35
United Facility/Professional Professional Modifier Low / Median / High Price $353.07 / $521.66 / $1,000.25	Professional		$353.07	$521.66	$1,000.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.20 / $113.06 / $211.61	Professional	26	$84.20	$113.06	$211.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.61 / $337.47 / $836.32	Professional	TC	$249.61	$337.47	$836.32