Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.03 / $108.72 / $268.60	Facility	26	$76.03	$108.72	$268.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $395.80 / $583.44 / $1,357.98	Professional		$395.80	$583.44	$1,357.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.87 / $100.15 / $198.39	Professional	26	$71.87	$100.15	$198.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $319.77 / $468.45 / $734.13	Professional	TC	$319.77	$468.45	$734.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $283.97 / $283.97 / $394.82	Professional		$283.97	$283.97	$394.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.25 / $93.37 / $117.12	Professional	26	$62.25	$93.37	$117.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.58 / $431.18 / $673.58	Professional		$323.58	$431.18	$673.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.84 / $99.04 / $144.74	Professional	26	$79.84	$99.04	$144.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $243.74 / $333.68 / $523.33	Professional	TC	$243.74	$333.68	$523.33
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $465.40 / $465.40 / $721.77	Professional		$465.40	$465.40	$721.77
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $91.82 / $91.82 / $142.38	Professional	26	$91.82	$91.82	$142.38
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $373.59 / $373.59 / $579.38	Professional	TC	$373.59	$373.59	$579.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.59 / $394.41 / $595.40	Professional		$85.59	$394.41	$595.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.44 / $128.44 / $128.44	Facility	26	$128.44	$128.44	$128.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $397.29 / $571.82 / $1,069.10	Professional		$397.29	$571.82	$1,069.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.65 / $106.92 / $188.00	Professional	26	$77.65	$106.92	$188.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $321.87 / $466.78 / $880.98	Professional	TC	$321.87	$466.78	$880.98
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $128.44 / $128.44 / $128.44	Facility	26	$128.44	$128.44	$128.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $382.46 / $564.24 / $970.48	Professional		$382.46	$564.24	$970.48
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $78.80 / $108.93 / $188.00	Professional	26	$78.80	$108.93	$188.00
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $342.38 / $462.83 / $809.15	Professional	TC	$342.38	$462.83	$809.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $103.96 / $391.11 / $627.77	Professional		$103.96	$391.11	$627.77
United Facility/Professional Professional Modifier Low / Median / High Price $304.88 / $517.13 / $919.55	Professional		$304.88	$517.13	$919.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.03 / $91.08 / $160.35	Professional	26	$62.03	$91.08	$160.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $280.39 / $427.41 / $747.78	Professional	TC	$280.39	$427.41	$747.78