Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.97 / $76.06 / $159.83	Facility	26	$45.97	$76.06	$159.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.40 / $145.97 / $275.75	Professional		$115.40	$145.97	$275.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.14 / $49.11 / $93.25	Professional	26	$42.14	$49.11	$93.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.76 / $96.10 / $178.29	Professional	TC	$73.76	$96.10	$178.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.73 / $59.51 / $66.69	Professional	26	$41.73	$59.51	$66.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.53 / $154.13 / $274.19	Professional		$136.53	$154.13	$274.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.28 / $54.78 / $96.85	Professional	26	$48.28	$54.78	$96.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $84.05 / $101.17 / $184.46	Professional	TC	$84.05	$101.17	$184.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $85.61 / $132.37	Professional		$46.76	$85.61	$132.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.50 / $51.84 / $51.84	Facility	26	$47.50	$51.84	$51.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.51 / $194.02 / $342.90	Professional		$126.51	$194.02	$342.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.35 / $60.68 / $102.90	Professional	26	$39.35	$60.68	$102.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.78 / $130.40 / $242.23	Professional	TC	$82.78	$130.40	$242.23
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $47.50 / $47.50 / $51.84	Facility	26	$47.50	$47.50	$51.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $126.51 / $193.17 / $336.95	Professional		$126.51	$193.17	$336.95
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $43.35 / $62.13 / $101.80	Professional	26	$43.35	$62.13	$101.80
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $83.86 / $126.53 / $237.39	Professional	TC	$83.86	$126.53	$237.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $115.47 / $179.83	Professional		$40.43	$115.47	$179.83
United Facility/Professional Professional Modifier Low / Median / High Price $128.04 / $167.63 / $307.31	Professional		$128.04	$167.63	$307.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.61 / $54.79 / $98.36	Professional	26	$37.61	$54.79	$98.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.42 / $114.63 / $206.86	Professional	TC	$83.42	$114.63	$206.86