Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.00 / $62.92 / $158.65	Facility	26	$44.00	$62.92	$158.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.58 / $240.06 / $424.25	Professional		$194.58	$240.06	$424.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.77 / $48.40 / $93.28	Professional	26	$42.77	$48.40	$93.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $150.57 / $186.24 / $337.08	Professional	TC	$150.57	$186.24	$337.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.43 / $148.43 / $148.43	Professional		$148.43	$148.43	$148.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.93 / $259.63 / $421.75	Professional		$235.93	$259.63	$421.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $56.49 / $90.70	Professional	26	$48.98	$56.49	$90.70
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $184.79 / $207.95 / $331.38	Professional	TC	$184.79	$207.95	$331.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.04 / $157.06 / $264.89	Professional		$47.04	$157.06	$264.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.62 / $296.87 / $509.94	Professional		$197.62	$296.87	$509.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $61.06 / $106.57	Professional	26	$43.88	$61.06	$106.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $153.76 / $237.75 / $403.37	Professional	TC	$153.76	$237.75	$403.37
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $197.62 / $291.52 / $494.52	Professional		$197.62	$291.52	$494.52
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $62.47 / $103.47	Professional	26	$43.88	$62.47	$103.47
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $153.76 / $228.45 / $393.63	Professional	TC	$153.76	$228.45	$393.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.71 / $196.64 / $287.40	Professional		$41.71	$196.64	$287.40
United Facility/Professional Professional Modifier Low / Median / High Price $182.73 / $256.42 / $462.23	Professional		$182.73	$256.42	$462.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.40 / $53.40 / $94.85	Professional	26	$37.40	$53.40	$94.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.88 / $203.69 / $352.45	Professional	TC	$146.88	$203.69	$352.45