Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.96 / $202.69 / $395.73	Facility	26	$114.96	$202.69	$395.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $205.02 / $238.88 / $459.83	Professional		$205.02	$238.88	$459.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.23 / $118.81 / $206.23	Professional	26	$106.23	$118.81	$206.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.93 / $117.06 / $217.84	Professional	TC	$101.93	$117.06	$217.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $326.14 / $326.14 / $365.34	Professional		$326.14	$326.14	$365.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.09 / $86.52 / $198.01	Professional	26	$86.09	$86.52	$198.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.31 / $321.36 / $606.89	Professional		$255.31	$321.36	$606.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $110.37 / $126.92 / $227.41	Professional	26	$110.37	$126.92	$227.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.27 / $192.23 / $376.23	Professional	TC	$137.27	$192.23	$376.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $118.37 / $295.10 / $413.48	Professional		$118.37	$295.10	$413.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.72 / $129.66 / $129.66	Facility	26	$117.72	$129.66	$129.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $375.89 / $545.04 / $958.95	Professional		$375.89	$545.04	$958.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.25 / $150.66 / $256.35	Professional	26	$97.25	$150.66	$256.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $268.27 / $393.10 / $698.42	Professional	TC	$268.27	$393.10	$698.42
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $117.72 / $117.72 / $129.66	Facility	26	$117.72	$117.72	$129.66
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $394.68 / $537.67 / $890.43	Professional		$394.68	$537.67	$890.43
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $107.61 / $150.66 / $252.41	Professional	26	$107.61	$150.66	$252.41
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $281.69 / $393.10 / $672.69	Professional	TC	$281.69	$393.10	$672.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.07 / $131.21 / $249.87	Professional		$87.07	$131.21	$249.87
United Facility/Professional Professional Modifier Low / Median / High Price $368.36 / $507.45 / $958.30	Professional		$368.36	$507.45	$958.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.69 / $135.05 / $241.60	Professional	26	$97.69	$135.05	$241.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $264.50 / $379.06 / $688.45	Professional	TC	$264.50	$379.06	$688.45