Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.79 / $151.25 / $295.30	Facility	26	$88.79	$151.25	$295.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $345.74 / $425.00 / $847.14	Professional		$345.74	$425.00	$847.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.55 / $112.50 / $183.92	Professional	26	$86.55	$112.50	$183.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $256.94 / $299.00 / $557.00	Professional	TC	$256.94	$299.00	$557.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $379.81 / $379.81 / $379.81	Professional	50	$379.81	$379.81	$379.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $350.57 / $422.24 / $708.38	Professional		$350.57	$422.24	$708.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.30 / $102.89 / $189.29	Professional	26	$85.30	$102.89	$189.29
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $525.85 / $633.12 / $1,062.57	Professional	50	$525.85	$633.12	$1,062.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $260.00 / $317.51 / $530.03	Professional	TC	$260.00	$317.51	$530.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.53 / $250.09 / $374.60	Professional		$88.53	$250.09	$374.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.94 / $97.37 / $97.37	Facility	26	$87.94	$97.37	$97.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.08 / $525.00 / $988.95	Professional		$326.08	$525.00	$988.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.95 / $115.30 / $192.41	Professional	26	$73.95	$115.30	$192.41
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $507.23 / $507.23 / $507.23	Professional	50	$507.23	$507.23	$507.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $242.74 / $403.50 / $743.08	Professional	TC	$242.74	$403.50	$743.08
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $87.94 / $87.94 / $97.37	Facility	26	$87.94	$87.94	$97.37
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $326.08 / $525.00 / $943.28	Professional		$326.08	$525.00	$943.28
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $80.98 / $116.70 / $191.97	Professional	26	$80.98	$116.70	$191.97
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $250.09 / $368.52 / $733.07	Professional	TC	$250.09	$368.52	$733.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.04 / $262.44 / $431.39	Professional		$96.04	$262.44	$431.39
United Facility/Professional Professional Modifier Low / Median / High Price $338.62 / $450.22 / $777.71	Professional		$338.62	$450.22	$777.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.55 / $99.24 / $180.26	Professional	26	$73.55	$99.24	$180.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $254.30 / $338.52 / $611.25	Professional	TC	$254.30	$338.52	$611.25