Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $127.03 / $210.20 / $420.23	Facility	26	$127.03	$210.20	$420.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $475.00 / $1,106.46	Professional		$375.00	$475.00	$1,106.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $122.40 / $154.00 / $264.41	Professional	26	$122.40	$154.00	$264.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.04 / $335.00 / $874.18	Professional	TC	$249.04	$335.00	$874.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $250.64 / $289.47 / $513.58	Professional		$250.64	$289.47	$513.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $92.18 / $136.11 / $190.98	Professional	26	$92.18	$136.11	$190.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $405.30 / $483.75 / $856.85	Professional		$405.30	$483.75	$856.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $122.13 / $150.21 / $282.75	Professional	26	$122.13	$150.21	$282.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $265.82 / $319.20 / $584.41	Professional	TC	$265.82	$319.20	$584.41
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $390.98 / $390.98 / $606.35	Professional		$390.98	$390.98	$606.35
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $135.96 / $135.96 / $210.85	Professional	26	$135.96	$135.96	$210.85
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $255.02 / $255.02 / $395.50	Professional	TC	$255.02	$255.02	$395.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $126.74 / $272.73 / $474.93	Professional		$126.74	$272.73	$474.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.53 / $139.38 / $139.38	Facility	26	$125.53	$139.38	$139.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $351.82 / $578.17 / $1,148.78	Professional		$351.82	$578.17	$1,148.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.94 / $164.36 / $275.26	Professional	26	$105.94	$164.36	$275.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.85 / $396.80 / $808.07	Professional	TC	$234.85	$396.80	$808.07
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $125.53 / $125.53 / $139.38	Facility	26	$125.53	$125.53	$139.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $347.90 / $563.27 / $1,148.78	Professional		$347.90	$563.27	$1,148.78
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $119.59 / $169.37 / $314.55	Professional	26	$119.59	$169.37	$314.55
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $239.35 / $379.63 / $766.25	Professional	TC	$239.35	$379.63	$766.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $133.24 / $249.93 / $465.63	Professional		$133.24	$249.93	$465.63
United Facility/Professional Professional Modifier Low / Median / High Price $370.83 / $490.56 / $898.00	Professional		$370.83	$490.56	$898.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.82 / $144.19 / $251.38	Professional	26	$109.82	$144.19	$251.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.27 / $355.56 / $626.23	Professional	TC	$263.27	$355.56	$626.23