Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.67 / $103.92 / $373.18	Facility	26	$72.67	$103.92	$373.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.29 / $591.19 / $1,902.36	Professional		$399.29	$591.19	$1,902.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.88 / $92.44 / $164.03	Professional	26	$69.88	$92.44	$164.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $326.62 / $414.12 / $692.43	Professional	TC	$326.62	$414.12	$692.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $302.08 / $302.08 / $320.97	Professional		$302.08	$302.08	$320.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.46 / $71.98 / $116.98	Professional	26	$56.46	$71.98	$116.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $400.84 / $488.47 / $751.99	Professional		$400.84	$488.47	$751.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.20 / $90.30 / $152.05	Professional	26	$76.20	$90.30	$152.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $324.43 / $400.44 / $615.41	Professional	TC	$324.43	$400.44	$615.41
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $445.58 / $445.58 / $445.58	Professional		$445.58	$445.58	$445.58
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $83.27 / $83.27 / $83.27	Professional	26	$83.27	$83.27	$83.27
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $362.30 / $362.30 / $362.30	Professional	TC	$362.30	$362.30	$362.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $77.63 / $377.61 / $711.85	Professional		$77.63	$377.61	$711.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $406.46 / $581.55 / $1,056.42	Professional		$406.46	$581.55	$1,056.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.70 / $102.93 / $176.21	Professional	26	$71.70	$102.93	$176.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $331.67 / $478.18 / $880.21	Professional	TC	$331.67	$478.18	$880.21
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $379.58 / $539.04 / $963.24	Professional		$379.58	$539.04	$963.24
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $71.70 / $103.73 / $171.23	Professional	26	$71.70	$103.73	$171.23
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $334.76 / $460.18 / $870.94	Professional	TC	$334.76	$460.18	$870.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $106.46 / $367.22 / $590.69	Professional		$106.46	$367.22	$590.69
United Facility/Professional Professional Modifier Low / Median / High Price $417.60 / $538.96 / $1,137.98	Professional		$417.60	$538.96	$1,137.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.67 / $95.08 / $168.97	Professional	26	$72.67	$95.08	$168.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $311.61 / $443.51 / $784.51	Professional	TC	$311.61	$443.51	$784.51