Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.65 / $136.13 / $334.33	Facility	26	$94.65	$136.13	$334.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.74 / $351.89 / $627.50	Professional		$293.74	$351.89	$627.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.57 / $102.65 / $171.24	Professional	26	$89.57	$102.65	$171.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.15 / $241.02 / $426.90	Professional	TC	$204.15	$241.02	$426.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.79 / $99.18 / $99.18	Professional	26	$77.79	$99.18	$99.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $300.08 / $367.48 / $558.52	Professional		$300.08	$367.48	$558.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.35 / $117.72 / $176.31	Professional	26	$99.35	$117.72	$176.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $199.72 / $247.26 / $376.84	Professional	TC	$199.72	$247.26	$376.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $106.96 / $239.76 / $346.72	Professional		$106.96	$239.76	$346.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $160.07 / $160.07 / $160.07	Facility	26	$160.07	$160.07	$160.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.83 / $423.01 / $735.07	Professional		$310.83	$423.01	$735.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $98.28 / $134.19 / $226.70	Professional	26	$98.28	$134.19	$226.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $211.83 / $287.93 / $508.38	Professional	TC	$211.83	$287.93	$508.38
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $160.07 / $160.07 / $160.07	Facility	26	$160.07	$160.07	$160.07
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $304.62 / $426.47 / $706.05	Professional		$304.62	$426.47	$706.05
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $98.28 / $136.13 / $258.54	Professional	26	$98.28	$136.13	$258.54
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $210.62 / $290.38 / $486.20	Professional	TC	$210.62	$290.38	$486.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $103.96 / $257.84 / $442.42	Professional		$103.96	$257.84	$442.42
United Facility/Professional Professional Modifier Low / Median / High Price $269.02 / $371.73 / $637.99	Professional		$269.02	$371.73	$637.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.88 / $117.84 / $201.12	Professional	26	$84.88	$117.84	$201.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $182.36 / $256.08 / $442.56	Professional	TC	$182.36	$256.08	$442.56