Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.39 / $155.00 / $362.21	Facility	26	$108.39	$155.00	$362.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $349.25 / $475.00 / $1,064.27	Professional		$349.25	$475.00	$1,064.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.55 / $145.65 / $380.80	Professional	26	$104.55	$145.65	$380.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $240.85 / $335.00 / $869.28	Professional	TC	$240.85	$335.00	$869.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $247.88 / $263.38 / $356.33	Professional		$247.88	$263.38	$356.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $78.76 / $99.39 / $172.29	Professional	26	$78.76	$99.39	$172.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $368.70 / $472.62 / $797.68	Professional		$368.70	$472.62	$797.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.70 / $120.93 / $227.16	Professional	26	$83.70	$120.93	$227.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $264.25 / $342.00 / $564.30	Professional	TC	$264.25	$342.00	$564.30
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $365.62 / $405.90 / $567.03	Professional		$365.62	$405.90	$567.03
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $116.17 / $128.97 / $180.16	Professional	26	$116.17	$128.97	$180.16
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $249.45 / $276.93 / $386.86	Professional	TC	$249.45	$276.93	$386.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.30 / $266.76 / $448.11	Professional		$108.30	$266.76	$448.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.73 / $118.86 / $118.86	Facility	26	$107.73	$118.86	$118.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $328.35 / $597.27 / $1,253.69	Professional		$328.35	$597.27	$1,253.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.34 / $141.33 / $235.00	Professional	26	$90.34	$141.33	$235.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.47 / $443.94 / $1,045.65	Professional	TC	$231.47	$443.94	$1,045.65
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $107.73 / $107.73 / $118.86	Facility	26	$107.73	$107.73	$118.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $315.22 / $568.90 / $1,237.60	Professional		$315.22	$568.90	$1,237.60
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $102.98 / $162.74 / $326.75	Professional	26	$102.98	$162.74	$326.75
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $232.54 / $408.27 / $974.72	Professional	TC	$232.54	$408.27	$974.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.87 / $247.52 / $425.35	Professional		$98.87	$247.52	$425.35
United Facility/Professional Professional Modifier Low / Median / High Price $344.82 / $478.21 / $1,021.94	Professional		$344.82	$478.21	$1,021.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.87 / $127.45 / $223.76	Professional	26	$93.87	$127.45	$223.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.34 / $335.77 / $824.60	Professional	TC	$244.34	$335.77	$824.60