Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.51 / $91.87 / $182.70	Facility	26	$50.51	$91.87	$182.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.26 / $198.68 / $376.31	Professional		$186.26	$198.68	$376.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.19 / $50.51 / $93.58	Professional	26	$44.19	$50.51	$93.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.47 / $144.97 / $284.06	Professional	TC	$140.47	$144.97	$284.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.16 / $96.03 / $378.66	Professional		$75.16	$96.03	$378.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.22 / $39.22 / $40.09	Professional	26	$39.22	$39.22	$40.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.07 / $243.66 / $435.39	Professional		$190.07	$243.66	$435.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.35 / $62.09 / $109.31	Professional	26	$47.35	$62.09	$109.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $142.04 / $182.75 / $326.33	Professional	TC	$142.04	$182.75	$326.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.94 / $146.60 / $200.54	Professional		$53.94	$146.60	$200.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.42 / $59.80 / $59.80	Facility	26	$54.42	$59.80	$59.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.68 / $288.91 / $510.47	Professional		$186.68	$288.91	$510.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.45 / $70.01 / $118.23	Professional	26	$45.45	$70.01	$118.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.26 / $213.24 / $363.94	Professional	TC	$139.26	$213.24	$363.94
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $54.42 / $54.42 / $59.80	Facility	26	$54.42	$54.42	$59.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $195.17 / $288.91 / $528.91	Professional		$195.17	$288.91	$528.91
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $49.71 / $71.17 / $117.87	Professional	26	$49.71	$71.17	$117.87
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $146.44 / $206.80 / $359.36	Professional	TC	$146.44	$206.80	$359.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $183.27 / $277.73	Professional		$40.54	$183.27	$277.73
United Facility/Professional Professional Modifier Low / Median / High Price $181.74 / $239.18 / $448.46	Professional		$181.74	$239.18	$448.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.35 / $61.92 / $110.24	Professional	26	$47.35	$61.92	$110.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.91 / $180.22 / $348.69	Professional	TC	$137.91	$180.22	$348.69