Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.16 / $101.24 / $240.62	Facility	26	$72.16	$101.24	$240.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.93 / $371.67 / $700.00	Professional		$202.93	$371.67	$700.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.15 / $123.25 / $249.57	Professional	26	$72.15	$123.25	$249.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.76 / $249.00 / $557.00	Professional	TC	$130.76	$249.00	$557.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.09 / $149.75 / $185.05	Professional		$136.09	$149.75	$185.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.91 / $77.87 / $119.39	Professional	26	$51.91	$77.87	$119.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.73 / $367.19 / $671.38	Professional		$258.73	$367.19	$671.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.15 / $82.19 / $146.38	Professional	26	$72.15	$82.19	$146.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.76 / $285.00 / $534.94	Professional	TC	$158.76	$285.00	$534.94
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $212.27 / $212.27 / $329.20	Professional		$212.27	$212.27	$329.20
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $76.56 / $76.56 / $118.75	Professional	26	$76.56	$76.56	$118.75
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $135.69 / $135.69 / $210.45	Professional	TC	$135.69	$135.69	$210.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.38 / $149.50 / $252.83	Professional		$71.38	$149.50	$252.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.67 / $79.09 / $79.09	Facility	26	$71.67	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.09 / $374.51 / $728.62	Professional		$190.09	$374.51	$728.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.12 / $92.83 / $156.83	Professional	26	$60.12	$92.83	$156.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.64 / $262.50 / $589.65	Professional	TC	$125.64	$262.50	$589.65
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $71.67 / $71.67 / $79.09	Facility	26	$71.67	$71.67	$79.09
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $190.09 / $352.44 / $753.71	Professional		$190.09	$352.44	$753.71
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $68.13 / $100.34 / $163.55	Professional	26	$68.13	$100.34	$163.55
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $126.50 / $235.76 / $544.28	Professional	TC	$126.50	$235.76	$544.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.67 / $135.29 / $218.39	Professional		$65.67	$135.29	$218.39
United Facility/Professional Professional Modifier Low / Median / High Price $197.13 / $302.33 / $615.67	Professional		$197.13	$302.33	$615.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.06 / $81.08 / $146.12	Professional	26	$60.06	$81.08	$146.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.77 / $198.55 / $460.62	Professional	TC	$137.77	$198.55	$460.62