Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.19 / $146.36 / $285.75	Facility	26	$85.19	$146.36	$285.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.63 / $383.86 / $660.66	Professional		$311.63	$383.86	$660.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.34 / $111.15 / $155.65	Professional	26	$83.34	$111.15	$155.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.44 / $275.89 / $460.96	Professional	TC	$226.44	$275.89	$460.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $299.52 / $299.52 / $299.52	Professional		$299.52	$299.52	$299.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.52 / $67.04 / $123.04	Professional	26	$61.52	$67.04	$123.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $339.75 / $420.12 / $747.18	Professional		$339.75	$420.12	$747.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.94 / $90.63 / $174.56	Professional	26	$63.94	$90.63	$174.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $248.14 / $328.87 / $564.30	Professional	TC	$248.14	$328.87	$564.30
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $325.94 / $325.94 / $325.94	Professional		$325.94	$325.94	$325.94
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $90.74 / $90.74 / $90.74	Professional	26	$90.74	$90.74	$90.74
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $235.20 / $235.20 / $235.20	Professional	TC	$235.20	$235.20	$235.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.59 / $219.25 / $339.60	Professional		$84.59	$219.25	$339.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.02 / $93.41 / $93.41	Facility	26	$85.02	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.62 / $515.10 / $1,005.41	Professional		$293.62	$515.10	$1,005.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.98 / $110.95 / $185.70	Professional	26	$70.98	$110.95	$185.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $217.61 / $399.25 / $788.18	Professional	TC	$217.61	$399.25	$788.18
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $85.02 / $85.02 / $93.41	Facility	26	$85.02	$85.02	$93.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $293.70 / $508.34 / $1,009.16	Professional		$293.70	$508.34	$1,009.16
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $79.12 / $112.12 / $176.88	Professional	26	$79.12	$112.12	$176.88
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $219.25 / $367.50 / $771.09	Professional	TC	$219.25	$367.50	$771.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $241.53 / $390.16	Professional		$98.87	$241.53	$390.16
United Facility/Professional Professional Modifier Low / Median / High Price $309.39 / $441.57 / $831.90	Professional		$309.39	$441.57	$831.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.69 / $97.66 / $174.18	Professional	26	$72.69	$97.66	$174.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $228.53 / $346.79 / $614.19	Professional	TC	$228.53	$346.79	$614.19