Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.17 / $127.51 / $317.33	Facility	26	$89.17	$127.51	$317.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.62 / $188.65 / $353.48	Professional		$146.62	$188.65	$353.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $89.17 / $167.96	Professional	26	$56.82	$89.17	$167.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.60 / $97.22 / $243.50	Professional	TC	$63.60	$97.22	$243.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.73 / $74.80 / $88.69	Professional	26	$66.73	$74.80	$88.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $219.13 / $313.83 / $571.46	Professional		$219.13	$313.83	$571.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.80 / $85.44 / $145.08	Professional	26	$65.80	$85.44	$145.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.72 / $242.19 / $446.62	Professional	TC	$84.72	$242.19	$446.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.45 / $95.65 / $165.10	Professional		$69.45	$95.65	$165.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $105.26 / $111.57	Facility	26	$105.26	$105.26	$111.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.66 / $254.19 / $540.29	Professional		$149.66	$254.19	$540.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.97 / $100.35 / $193.51	Professional	26	$69.97	$100.35	$193.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.14 / $131.26 / $455.42	Professional	TC	$63.14	$131.26	$455.42
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $105.26 / $111.57	Facility	26	$105.26	$105.26	$111.57
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $150.80 / $240.14 / $596.24	Professional		$150.80	$240.14	$596.24
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $72.00 / $106.08 / $182.59	Professional	26	$72.00	$106.08	$182.59
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $66.30 / $114.46 / $371.94	Professional	TC	$66.30	$114.46	$371.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.71 / $116.40 / $212.83	Professional		$63.71	$116.40	$212.83
United Facility/Professional Professional Modifier Low / Median / High Price $157.96 / $218.70 / $506.11	Professional		$157.96	$218.70	$506.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.83 / $101.27 / $188.66	Professional	26	$60.83	$101.27	$188.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.88 / $96.58 / $276.52	Professional	TC	$67.88	$96.58	$276.52