Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.27 / $139.21 / $352.96	Facility	26	$106.27	$139.21	$352.96
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 $106.19 / $140.00 / $289.47	Professional	26	$106.19	$140.00	$289.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $271.38 / $335.00 / $631.87	Professional	TC	$271.38	$335.00	$631.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $266.43 / $304.49 / $727.69	Professional		$266.43	$304.49	$727.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.23 / $95.75 / $135.16	Professional	26	$77.23	$95.75	$135.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.52 / $455.87 / $750.00	Professional		$337.52	$455.87	$750.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.52 / $114.26 / $217.26	Professional	26	$77.52	$114.26	$217.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.00 / $333.92 / $537.47	Professional	TC	$260.00	$333.92	$537.47
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $413.79 / $413.79 / $455.87	Professional		$413.79	$413.79	$455.87
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $113.92 / $113.92 / $125.50	Professional	26	$113.92	$113.92	$125.50
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $299.87 / $299.87 / $330.37	Professional	TC	$299.87	$299.87	$330.37
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.19 / $320.81 / $505.91	Professional		$106.19	$320.81	$505.91
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 $372.74 / $634.78 / $1,279.16	Professional		$372.74	$634.78	$1,279.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.57 / $137.90 / $229.74	Professional	26	$88.57	$137.90	$229.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $279.54 / $480.22 / $1,022.31	Professional	TC	$279.54	$480.22	$1,022.31
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 $374.66 / $631.20 / $1,349.05	Professional		$374.66	$631.20	$1,349.05
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $98.57 / $143.91 / $246.13	Professional	26	$98.57	$143.91	$246.13
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $279.68 / $452.03 / $959.22	Professional	TC	$279.68	$452.03	$959.22
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 $392.39 / $548.05 / $1,028.70	Professional		$392.39	$548.05	$1,028.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.90 / $116.43 / $212.26	Professional	26	$87.90	$116.43	$212.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $296.33 / $392.48 / $833.35	Professional	TC	$296.33	$392.48	$833.35