Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.49 / $53.88 / $138.94	Facility	26	$38.49	$53.88	$138.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.62 / $277.43 / $525.54	Professional		$229.62	$277.43	$525.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.26 / $51.12 / $116.22	Professional	26	$37.26	$51.12	$116.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.87 / $236.59 / $443.93	Professional	TC	$192.87	$236.59	$443.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.47 / $94.47 / $188.94	Professional		$94.47	$94.47	$188.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.16 / $49.01 / $62.49	Professional	26	$30.16	$49.01	$62.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.52 / $240.41 / $390.84	Professional		$197.52	$240.41	$390.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.04 / $49.15 / $79.13	Professional	26	$43.04	$49.15	$79.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $152.47 / $193.78 / $307.77	Professional	TC	$152.47	$193.78	$307.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.47 / $236.18 / $460.18	Professional		$41.47	$236.18	$460.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.38 / $330.65 / $603.39	Professional		$235.38	$330.65	$603.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.77 / $54.06 / $92.40	Professional	26	$38.77	$54.06	$92.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $195.40 / $276.18 / $511.07	Professional	TC	$195.40	$276.18	$511.07
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $225.66 / $333.45 / $644.46	Professional		$225.66	$333.45	$644.46
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $39.07 / $60.32 / $108.00	Professional	26	$39.07	$60.32	$108.00
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $197.45 / $273.54 / $500.78	Professional	TC	$197.45	$273.54	$500.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $265.92 / $391.53	Professional		$42.05	$265.92	$391.53
United Facility/Professional Professional Modifier Low / Median / High Price $185.71 / $311.08 / $562.88	Professional		$185.71	$311.08	$562.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.88 / $45.38 / $82.97	Professional	26	$28.88	$45.38	$82.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.38 / $267.42 / $508.10	Professional	TC	$152.38	$267.42	$508.10