Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.13 / $81.70 / $196.67	Facility	26	$57.13	$81.70	$196.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.72 / $175.34 / $416.79	Professional		$137.72	$175.34	$416.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.83 / $61.36 / $180.24	Professional	26	$52.83	$61.36	$180.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.59 / $119.70 / $273.26	Professional	TC	$80.59	$119.70	$273.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.61 / $107.06 / $131.61	Professional		$103.61	$107.06	$131.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.07 / $54.95 / $87.57	Professional	26	$42.07	$54.95	$87.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.47 / $229.72 / $440.46	Professional		$163.47	$229.72	$440.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.19 / $66.75 / $119.57	Professional	26	$59.19	$66.75	$119.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $94.11 / $169.03 / $311.69	Professional	TC	$94.11	$169.03	$311.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.11 / $95.06 / $171.54	Professional		$58.11	$95.06	$171.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.50 / $64.44 / $64.44	Facility	26	$58.50	$64.44	$64.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.25 / $214.97 / $429.12	Professional		$132.25	$214.97	$429.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $75.44 / $128.66	Professional	26	$48.98	$75.44	$128.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.63 / $133.03 / $285.88	Professional	TC	$77.63	$133.03	$285.88
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $58.50 / $58.50 / $64.44	Facility	26	$58.50	$58.50	$64.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $132.25 / $214.64 / $430.47	Professional		$132.25	$214.64	$430.47
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $54.64 / $79.25 / $133.94	Professional	26	$54.64	$79.25	$133.94
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $77.95 / $123.58 / $275.51	Professional	TC	$77.95	$123.58	$275.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.55 / $87.34 / $173.29	Professional		$40.55	$87.34	$173.29
United Facility/Professional Professional Modifier Low / Median / High Price $132.66 / $186.03 / $346.31	Professional		$132.66	$186.03	$346.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.25 / $66.94 / $122.44	Professional	26	$47.25	$66.94	$122.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.68 / $115.14 / $209.18	Professional	TC	$78.68	$115.14	$209.18