Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $97.72 / $141.25	Facility	26	$74.13	$97.72	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $489.78 / $1,698.24	Professional		$338.84	$489.78	$1,698.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $125.89 / $269.15	Professional	26	$70.79	$125.89	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $380.19 / $912.01	Professional	TC	$281.84	$380.19	$912.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $67.61 / $123.03	Professional	26	$54.95	$67.61	$123.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $446.68 / $691.83	Professional		$354.81	$446.68	$691.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $147.91	Professional	26	$75.86	$95.50	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $354.81 / $537.03	Professional	TC	$275.42	$354.81	$537.03
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Professional		$436.52	$436.52	$436.52
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $85.11 / $85.11	Professional	26	$85.11	$85.11	$85.11
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	TC	$354.81	$354.81	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $1,047.13	Professional		$316.23	$478.63	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $102.33 / $181.97	Professional	26	$69.18	$102.33	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $389.05 / $870.96	Professional	TC	$281.84	$389.05	$870.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $489.78 / $912.01	Professional		$363.08	$489.78	$912.01
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $109.65 / $177.83	Professional	26	$70.79	$109.65	$177.83
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $398.11 / $758.58	Professional	TC	$295.12	$398.11	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	26	$660.69	$660.69	$660.69
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $524.81 / $831.76	Professional		$389.05	$524.81	$831.76
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $109.65 / $162.18	Professional	26	$75.86	$109.65	$162.18
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $416.87 / $660.69	Professional	TC	$316.23	$416.87	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $426.58 / $741.31	Professional		$302.00	$426.58	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $85.11 / $147.91	Professional	26	$60.26	$85.11	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $346.74 / $616.60	Professional	TC	$234.42	$346.74	$616.60