Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.98 / $132.69 / $263.77	Facility	26	$72.98	$132.69	$263.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.82 / $260.95 / $494.18	Professional		$206.82	$260.95	$494.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.95 / $96.10 / $145.65	Professional	26	$67.95	$96.10	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.34 / $170.91 / $335.00	Professional	TC	$136.34	$170.91	$335.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.91 / $173.62 / $413.85	Professional		$151.91	$173.62	$413.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.95 / $56.95 / $99.65	Professional	26	$56.95	$56.95	$99.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.87 / $265.27 / $485.46	Professional		$206.87	$265.27	$485.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $68.36 / $89.65 / $157.62	Professional	26	$68.36	$89.65	$157.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $137.84 / $177.24 / $316.72	Professional	TC	$137.84	$177.24	$316.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.30 / $142.71 / $221.01	Professional		$78.30	$142.71	$221.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.53 / $86.45 / $86.45	Facility	26	$78.53	$86.45	$86.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.44 / $308.45 / $527.63	Professional		$201.44	$308.45	$527.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.70 / $101.63 / $171.32	Professional	26	$65.70	$101.63	$171.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.05 / $207.38 / $353.11	Professional	TC	$135.05	$207.38	$353.11
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $78.53 / $78.53 / $86.45	Facility	26	$78.53	$78.53	$86.45
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $212.48 / $308.45 / $516.89	Professional		$212.48	$308.45	$516.89
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $70.45 / $102.60 / $174.43	Professional	26	$70.45	$102.60	$174.43
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $142.03 / $200.69 / $348.75	Professional	TC	$142.03	$200.69	$348.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.94 / $153.55 / $296.69	Professional		$96.94	$153.55	$296.69
United Facility/Professional Professional Modifier Low / Median / High Price $228.78 / $355.33 / $985.22	Professional		$228.78	$355.33	$985.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $65.56 / $89.62 / $163.63	Professional	26	$65.56	$89.62	$163.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.74 / $218.31 / $814.47	Professional	TC	$151.74	$218.31	$814.47