Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.12 / $174.21 / $344.66	Facility	26	$97.12	$174.21	$344.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $362.74 / $458.97 / $787.01	Professional		$362.74	$458.97	$787.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.01 / $123.00 / $231.29	Professional	26	$94.01	$123.00	$231.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $265.62 / $323.22 / $560.37	Professional	TC	$265.62	$323.22	$560.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $260.73 / $260.73 / $260.73	Professional		$260.73	$260.73	$260.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.56 / $105.66 / $154.15	Professional	26	$79.56	$105.66	$154.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $364.53 / $470.75 / $779.72	Professional		$364.53	$470.75	$779.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.51 / $116.74 / $188.99	Professional	26	$92.51	$116.74	$188.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $272.02 / $349.19 / $592.38	Professional	TC	$272.02	$349.19	$592.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.40 / $288.95 / $398.33	Professional		$109.40	$288.95	$398.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $164.81 / $164.81 / $164.81	Facility	26	$164.81	$164.81	$164.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.23 / $533.90 / $891.18	Professional		$380.23	$533.90	$891.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.09 / $137.24 / $232.84	Professional	26	$100.09	$137.24	$232.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.81 / $397.98 / $658.34	Professional	TC	$275.81	$397.98	$658.34
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $164.81 / $164.81 / $164.81	Facility	26	$164.81	$164.81	$164.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $398.33 / $533.90 / $862.36	Professional		$398.33	$533.90	$862.36
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $101.30 / $139.22 / $266.04	Professional	26	$101.30	$139.22	$266.04
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $288.94 / $397.47 / $648.67	Professional	TC	$288.94	$397.47	$648.67
Molina Facility/Professional Professional Modifier Low / Median / High Price $103.96 / $326.65 / $529.82	Professional		$103.96	$326.65	$529.82
United Facility/Professional Professional Modifier Low / Median / High Price $359.97 / $497.70 / $837.97	Professional		$359.97	$497.70	$837.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.66 / $117.29 / $208.57	Professional	26	$82.66	$117.29	$208.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $264.11 / $373.60 / $629.40	Professional	TC	$264.11	$373.60	$629.40