Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.83 / $76.98 / $193.42	Facility	26	$53.83	$76.98	$193.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.42 / $330.02 / $626.29	Professional		$295.42	$330.02	$626.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.03 / $55.45 / $114.12	Professional	26	$49.03	$55.45	$114.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $241.59 / $280.99 / $512.16	Professional	TC	$241.59	$280.99	$512.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.22 / $54.36 / $73.18	Professional	26	$41.22	$54.36	$73.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $319.91 / $375.44 / $615.75	Professional		$319.91	$375.44	$615.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.22 / $64.98 / $104.54	Professional	26	$54.22	$64.98	$104.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $265.70 / $311.26 / $511.22	Professional	TC	$265.70	$311.26	$511.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $252.03 / $353.98	Professional		$35.39	$252.03	$353.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $304.77 / $462.52 / $780.41	Professional		$304.77	$462.52	$780.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.16 / $75.59 / $129.26	Professional	26	$53.16	$75.59	$129.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $252.03 / $384.96 / $651.15	Professional	TC	$252.03	$384.96	$651.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $304.77 / $436.26 / $757.10	Professional		$304.77	$436.26	$757.10
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $53.16 / $74.50 / $125.63	Professional	26	$53.16	$74.50	$125.63
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $252.03 / $365.16 / $634.53	Professional	TC	$252.03	$365.16	$634.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.71 / $299.85 / $441.66	Professional		$41.71	$299.85	$441.66
United Facility/Professional Professional Modifier Low / Median / High Price $287.64 / $379.89 / $693.94	Professional		$287.64	$379.89	$693.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.46 / $66.23 / $114.90	Professional	26	$47.46	$66.23	$114.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $230.52 / $319.14 / $580.11	Professional	TC	$230.52	$319.14	$580.11