Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.30 / $209.51 / $497.97	Facility	26	$140.30	$209.51	$497.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $336.75 / $410.23 / $825.94	Professional		$336.75	$410.23	$825.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $143.11 / $255.06	Professional	26	$131.81	$143.11	$255.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.33 / $269.93 / $572.25	Professional	TC	$199.33	$269.93	$572.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $202.59 / $202.59 / $202.59	Professional	26	$202.59	$202.59	$202.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.82 / $411.87 / $657.51	Professional		$284.82	$411.87	$657.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $122.77 / $169.13 / $257.54	Professional	26	$122.77	$169.13	$257.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $167.71 / $231.32 / $401.00	Professional	TC	$167.71	$231.32	$401.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $159.18 / $302.13 / $461.31	Professional		$159.18	$302.13	$461.31
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 $382.08 / $524.21 / $966.21	Professional		$382.08	$524.21	$966.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $145.30 / $199.06 / $335.49	Professional	26	$145.30	$199.06	$335.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $227.39 / $340.17 / $603.19	Professional	TC	$227.39	$340.17	$603.19
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 $372.29 / $524.21 / $880.67	Professional		$372.29	$524.21	$880.67
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $145.41 / $201.09 / $383.04	Professional	26	$145.41	$201.09	$383.04
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $226.87 / $343.32 / $576.79	Professional	TC	$226.87	$343.32	$576.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $172.35 / $331.90 / $605.18	Professional		$172.35	$331.90	$605.18
United Facility/Professional Professional Modifier Low / Median / High Price $305.75 / $438.47 / $793.36	Professional		$305.75	$438.47	$793.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $124.23 / $172.49 / $298.27	Professional	26	$124.23	$172.49	$298.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $179.13 / $279.41 / $495.08	Professional	TC	$179.13	$279.41	$495.08