Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.38 / $103.94 / $181.12	Facility	26	$90.38	$103.94	$181.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.82 / $198.74 / $454.38	Professional		$141.82	$198.74	$454.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.34 / $90.38 / $164.52	Professional	26	$49.34	$90.38	$164.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.93 / $122.88 / $147.59	Professional	26	$52.93	$122.88	$147.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.86 / $278.95 / $516.04	Professional		$196.86	$278.95	$516.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.69 / $73.90 / $130.38	Professional	26	$56.69	$73.90	$130.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.28 / $97.94 / $173.24	Professional		$75.28	$97.94	$173.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.37 / $106.98 / $106.98	Facility	26	$64.37	$106.98	$106.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.61 / $238.94 / $531.97	Professional		$149.61	$238.94	$531.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.08 / $97.95 / $182.54	Professional	26	$62.08	$97.95	$182.54
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $64.37 / $64.37 / $106.98	Facility	26	$64.37	$64.37	$106.98
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $149.74 / $231.50 / $559.47	Professional		$149.74	$231.50	$559.47
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $66.17 / $102.40 / $186.99	Professional	26	$66.17	$102.40	$186.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.71 / $116.32 / $212.83	Professional		$63.71	$116.32	$212.83
United Facility/Professional Professional Modifier Low / Median / High Price $143.22 / $215.82 / $494.72	Professional		$143.22	$215.82	$494.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.83 / $98.67 / $178.05	Professional	26	$53.83	$98.67	$178.05