Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.66 / $520.64 / $2,812.76	Facility		$142.66	$520.64	$2,812.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.81 / $114.13 / $285.02	Facility	26	$79.81	$114.13	$285.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.71 / $192.59 / $478.02	Professional		$132.71	$192.59	$478.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $79.81 / $151.38	Professional	26	$48.86	$79.81	$151.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $64.06 / $71.33 / $136.32	Professional	52	$64.06	$71.33	$136.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.88 / $86.01 / $247.25	Professional	TC	$61.88	$86.01	$247.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.99 / $113.99 / $113.99	Professional		$113.99	$113.99	$113.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.77 / $100.39 / $119.69	Professional	26	$61.77	$100.39	$119.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.14 / $283.66 / $513.41	Professional		$188.14	$283.66	$513.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.11 / $74.80 / $129.53	Professional	26	$58.11	$74.80	$129.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $78.67 / $220.12 / $404.80	Professional	TC	$78.67	$220.12	$404.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.56 / $97.50 / $184.71	Facility		$65.56	$97.50	$184.71
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $100.39 / $186.48	Professional		$65.56	$100.39	$186.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $188.07 / $5,752.36 / $9,420.04	Facility		$188.07	$5,752.36	$9,420.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $94.06 / $99.39	Facility	26	$94.06	$94.06	$99.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.82 / $231.30 / $523.38	Professional		$136.82	$231.30	$523.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.78 / $89.39 / $169.57	Professional	26	$61.78	$89.39	$169.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.45 / $118.08 / $440.85	Professional	TC	$60.45	$118.08	$440.85
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $216.47 / $5,752.36 / $9,420.04	Facility		$216.47	$5,752.36	$9,420.04
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $94.06 / $94.06 / $99.39	Facility	26	$94.06	$94.06	$99.39
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $137.84 / $218.91 / $560.61	Professional		$137.84	$218.91	$560.61
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $64.00 / $95.75 / $162.16	Professional	26	$64.00	$95.75	$162.16
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $62.58 / $109.25 / $323.58	Professional	TC	$62.58	$109.25	$323.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $97.24 / $176.01	Professional		$59.64	$97.24	$176.01
United Facility/Professional Professional Modifier Low / Median / High Price $148.18 / $205.23 / $496.06	Professional		$148.18	$205.23	$496.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.32 / $93.85 / $167.69	Professional	26	$55.32	$93.85	$167.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.97 / $94.40 / $236.41	Professional	TC	$66.97	$94.40	$236.41