Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.03 / $150.60 / $294.02	Facility	26	$88.03	$150.60	$294.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.61 / $431.47 / $844.75	Professional		$346.61	$431.47	$844.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.16 / $125.88 / $189.00	Professional	26	$86.16	$125.88	$189.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $258.58 / $322.14 / $581.79	Professional	TC	$258.58	$322.14	$581.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.02 / $64.16 / $103.79	Professional	26	$47.02	$64.16	$103.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $373.93 / $429.37 / $731.48	Professional		$373.93	$429.37	$731.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.93 / $101.09 / $179.36	Professional	26	$88.93	$101.09	$179.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $279.07 / $330.17 / $564.30	Professional	TC	$279.07	$330.17	$564.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.82 / $250.73 / $376.63	Professional		$87.82	$250.73	$376.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.55 / $96.55 / $96.55	Facility	26	$87.55	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.08 / $525.00 / $988.64	Professional		$327.08	$525.00	$988.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.36 / $115.28 / $191.43	Professional	26	$73.36	$115.28	$191.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $243.37 / $406.91 / $763.31	Professional	TC	$243.37	$406.91	$763.31
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $87.55 / $87.55 / $96.55	Facility	26	$87.55	$87.55	$96.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $327.08 / $525.00 / $943.28	Professional		$327.08	$525.00	$943.28
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $80.28 / $115.76 / $191.13	Professional	26	$80.28	$115.76	$191.13
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $250.74 / $368.89 / $733.07	Professional	TC	$250.74	$368.89	$733.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.04 / $262.44 / $431.39	Professional		$96.04	$262.44	$431.39
United Facility/Professional Professional Modifier Low / Median / High Price $342.59 / $439.90 / $776.30	Professional		$342.59	$439.90	$776.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.19 / $94.96 / $176.06	Professional	26	$76.19	$94.96	$176.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.43 / $340.55 / $610.34	Professional	TC	$257.43	$340.55	$610.34