Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.20 / $114.70 / $268.30	Facility	26	$80.20	$114.70	$268.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.69 / $475.00 / $914.50	Professional		$322.69	$475.00	$914.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.20 / $128.72 / $170.05	Professional	26	$80.20	$128.72	$170.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.49 / $318.97 / $686.82	Professional	TC	$242.49	$318.97	$686.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $228.80 / $228.80 / $592.96	Professional		$228.80	$228.80	$592.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.11 / $59.17 / $115.87	Professional	26	$57.11	$59.17	$115.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.10 / $402.55 / $683.22	Professional		$317.10	$402.55	$683.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.10 / $85.43 / $163.38	Professional	26	$57.10	$85.43	$163.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.00 / $312.00 / $518.83	Professional	TC	$260.00	$312.00	$518.83
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $336.30 / $336.30 / $336.30	Professional		$336.30	$336.30	$336.30
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $85.46 / $85.46 / $85.46	Professional	26	$85.46	$85.46	$85.46
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $250.84 / $250.84 / $250.84	Professional	TC	$250.84	$250.84	$250.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.66 / $268.25 / $410.46	Professional		$79.66	$268.25	$410.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.90 / $87.95 / $87.95	Facility	26	$79.90	$87.95	$87.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.11 / $508.43 / $978.58	Professional		$303.11	$508.43	$978.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.86 / $104.86 / $175.75	Professional	26	$66.86	$104.86	$175.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $232.98 / $389.09 / $771.97	Professional	TC	$232.98	$389.09	$771.97
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $79.90 / $79.90 / $87.95	Facility	26	$79.90	$79.90	$87.95
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $304.77 / $508.43 / $987.14	Professional		$304.77	$508.43	$987.14
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $73.09 / $107.91 / $175.75	Professional	26	$73.09	$107.91	$175.75
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $233.84 / $361.39 / $743.68	Professional	TC	$233.84	$361.39	$743.68
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 $319.67 / $440.41 / $785.72	Professional		$319.67	$440.41	$785.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.27 / $91.08 / $162.91	Professional	26	$68.27	$91.08	$162.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.41 / $339.16 / $624.41	Professional	TC	$245.41	$339.16	$624.41