Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.24 / $297.77 / $737.71	Facility	26	$208.24	$297.77	$737.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $422.57 / $525.96 / $950.78	Professional		$422.57	$525.96	$950.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $200.11 / $295.33 / $565.65	Professional	26	$200.11	$295.33	$565.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.32 / $288.38 / $510.63	Professional	TC	$214.32	$288.38	$510.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $312.37 / $347.07 / $484.76	Professional		$312.37	$347.07	$484.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $170.96 / $217.97 / $320.55	Professional	26	$170.96	$217.97	$320.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $405.08 / $503.91 / $808.33	Professional		$405.08	$503.91	$808.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $225.08 / $263.70 / $437.46	Professional	26	$225.08	$263.70	$437.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $180.00 / $234.00 / $363.89	Professional	TC	$180.00	$234.00	$363.89
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $511.93 / $511.93 / $511.93	Professional		$511.93	$511.93	$511.93
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $252.17 / $252.17 / $252.17	Professional	26	$252.17	$252.17	$252.17
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $259.77 / $259.77 / $259.77	Professional	TC	$259.77	$259.77	$259.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $220.14 / $297.19 / $585.67	Professional		$220.14	$297.19	$585.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $353.10 / $353.10 / $353.10	Facility	26	$353.10	$353.10	$353.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $442.52 / $607.38 / $1,054.22	Professional		$442.52	$607.38	$1,054.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $215.22 / $298.05 / $497.23	Professional	26	$215.22	$298.05	$497.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $227.71 / $308.95 / $544.30	Professional	TC	$227.71	$308.95	$544.30
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $353.10 / $353.10 / $353.10	Facility	26	$353.10	$353.10	$353.10
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $445.85 / $623.57 / $1,184.26	Professional		$445.85	$623.57	$1,184.26
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $216.50 / $300.20 / $548.91	Professional	26	$216.50	$300.20	$548.91
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $230.63 / $308.20 / $495.17	Professional	TC	$230.63	$308.20	$495.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $199.87 / $289.54 / $602.00	Professional		$199.87	$289.54	$602.00
United Facility/Professional Professional Modifier Low / Median / High Price $374.14 / $549.10 / $917.99	Professional		$374.14	$549.10	$917.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $184.38 / $260.01 / $441.60	Professional	26	$184.38	$260.01	$441.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $189.76 / $284.04 / $474.86	Professional	TC	$189.76	$284.04	$474.86