Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.16 / $118.92 / $285.85	Facility	26	$83.16	$118.92	$285.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.93 / $279.27 / $450.73	Professional		$223.93	$279.27	$450.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.40 / $88.40 / $163.82	Professional	26	$74.40	$88.40	$163.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.63 / $191.62 / $294.57	Professional	TC	$145.63	$191.62	$294.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.77 / $98.84 / $108.11	Professional	26	$61.77	$98.84	$108.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.80 / $207.86 / $356.89	Professional		$146.80	$207.86	$356.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.84 / $95.34 / $173.54	Professional	26	$81.84	$95.34	$173.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.68 / $89.37 / $219.38	Professional	TC	$61.68	$89.37	$219.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.94 / $145.99 / $230.93	Professional		$84.94	$145.99	$230.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.23 / $93.84 / $93.84	Facility	26	$85.23	$93.84	$93.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.34 / $319.06 / $561.35	Professional		$220.34	$319.06	$561.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.31 / $110.23 / $185.77	Professional	26	$71.31	$110.23	$185.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.36 / $211.12 / $371.62	Professional	TC	$139.36	$211.12	$371.62
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $85.23 / $85.23 / $93.84	Facility	26	$85.23	$85.23	$93.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $223.10 / $309.10 / $558.01	Professional		$223.10	$309.10	$558.01
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $78.00 / $111.85 / $185.02	Professional	26	$78.00	$111.85	$185.02
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $141.33 / $201.18 / $357.17	Professional	TC	$141.33	$201.18	$357.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.94 / $153.55 / $296.69	Professional		$96.94	$153.55	$296.69
United Facility/Professional Professional Modifier Low / Median / High Price $217.91 / $284.81 / $529.99	Professional		$217.91	$284.81	$529.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.40 / $97.69 / $171.89	Professional	26	$72.40	$97.69	$171.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.59 / $188.84 / $348.63	Professional	TC	$140.59	$188.84	$348.63