Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.59 / $251.71 / $497.97	Facility	26	$140.59	$251.71	$497.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $259.82 / $296.83 / $511.84	Professional		$259.82	$296.83	$511.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $137.41 / $159.34 / $266.69	Professional	26	$137.41	$159.34	$266.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.22 / $145.68 / $252.75	Professional	TC	$119.22	$145.68	$252.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $192.35 / $192.35 / $192.35	Professional		$192.35	$192.35	$192.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $116.00 / $129.41 / $224.75	Professional	26	$116.00	$129.41	$224.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $226.95 / $320.39 / $480.88	Professional		$226.95	$320.39	$480.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $123.85 / $169.60 / $256.30	Professional	26	$123.85	$169.60	$256.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $104.78 / $147.91 / $225.97	Professional	TC	$104.78	$147.91	$225.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $134.37 / $159.50 / $293.88	Professional		$134.37	$159.50	$293.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $238.40 / $238.40 / $238.40	Facility	26	$238.40	$238.40	$238.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.43 / $368.75 / $610.77	Professional		$266.43	$368.75	$610.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $145.30 / $199.49 / $335.49	Professional	26	$145.30	$199.49	$335.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.69 / $167.58 / $281.68	Professional	TC	$120.69	$167.58	$281.68
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $238.40 / $238.40 / $238.40	Facility	26	$238.40	$238.40	$238.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $266.43 / $369.09 / $702.17	Professional		$266.43	$369.09	$702.17
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $145.72 / $201.69 / $383.88	Professional	26	$145.72	$201.69	$383.88
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $120.69 / $167.58 / $273.62	Professional	TC	$120.69	$167.58	$273.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $130.49 / $202.76 / $386.55	Professional		$130.49	$202.76	$386.55
United Facility/Professional Professional Modifier Low / Median / High Price $248.37 / $328.08 / $562.27	Professional		$248.37	$328.08	$562.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.42 / $168.42 / $296.32	Professional	26	$110.42	$168.42	$296.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.83 / $148.97 / $257.74	Professional	TC	$100.83	$148.97	$257.74