Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.24 / $148.30 / $1,489.01	Facility	26	$87.24	$148.30	$1,489.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $303.52 / $352.69 / $626.50	Professional		$303.52	$352.69	$626.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.65 / $111.40 / $300.25	Professional	26	$81.65	$111.40	$300.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $216.29 / $260.57 / $442.33	Professional	TC	$216.29	$260.57	$442.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $209.85 / $235.04 / $318.00	Professional		$209.85	$235.04	$318.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $96.66 / $142.91	Professional	26	$64.09	$96.66	$142.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $167.31 / $187.53 / $302.02	Professional	TC	$167.31	$187.53	$302.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $280.80 / $342.58 / $601.10	Professional		$280.80	$342.58	$601.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.26 / $109.64 / $209.69	Professional	26	$84.26	$109.64	$209.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $190.00 / $229.90 / $401.12	Professional	TC	$190.00	$229.90	$401.12
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $326.29 / $359.48 / $506.03	Professional		$326.29	$359.48	$506.03
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $96.36 / $106.16 / $149.44	Professional	26	$96.36	$106.16	$149.44
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $229.93 / $253.32 / $356.59	Professional	TC	$229.93	$253.32	$356.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.83 / $246.06 / $387.13	Professional		$89.83	$246.06	$387.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.57 / $98.40 / $98.40	Facility	26	$89.57	$98.40	$98.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.52 / $413.99 / $727.46	Professional		$276.52	$413.99	$727.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.79 / $115.46 / $195.53	Professional	26	$74.79	$115.46	$195.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.86 / $301.14 / $535.73	Professional	TC	$194.86	$301.14	$535.73
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $89.57 / $89.57 / $98.40	Facility	26	$89.57	$89.57	$98.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $403.87 / $749.94	Professional		$240.00	$403.87	$749.94
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $85.74 / $133.21 / $252.51	Professional	26	$85.74	$133.21	$252.51
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $203.64 / $301.14 / $547.26	Professional	TC	$203.64	$301.14	$547.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $237.20 / $390.16	Professional		$98.87	$237.20	$390.16
United Facility/Professional Professional Modifier Low / Median / High Price $272.54 / $360.31 / $657.17	Professional		$272.54	$360.31	$657.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.20 / $103.45 / $186.94	Professional	26	$76.20	$103.45	$186.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.27 / $253.79 / $458.22	Professional	TC	$190.27	$253.79	$458.22