Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.31 / $79.94 / $171.64	Facility	26	$48.31	$79.94	$171.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.73 / $357.47 / $677.59	Professional		$318.73	$357.47	$677.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.85 / $53.40 / $108.59	Professional	26	$45.85	$53.40	$108.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $271.31 / $308.92 / $575.17	Professional	TC	$271.31	$308.92	$575.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $241.80 / $241.80 / $241.80	Professional		$241.80	$241.80	$241.80
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.67 / $77.75 / $77.75	Professional	26	$65.67	$77.75	$77.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $261.62 / $321.38 / $530.02	Professional		$261.62	$321.38	$530.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $62.47 / $99.66	Professional	26	$54.95	$62.47	$99.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $206.67 / $250.07 / $431.94	Professional	TC	$206.67	$250.07	$431.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.60 / $280.89 / $332.49	Professional		$51.60	$280.89	$332.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.26 / $448.44 / $813.48	Professional		$302.26	$448.44	$813.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.77 / $66.68 / $115.95	Professional	26	$47.77	$66.68	$115.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $256.26 / $380.33 / $690.62	Professional	TC	$256.26	$380.33	$690.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $305.08 / $445.01 / $777.56	Professional		$305.08	$445.01	$777.56
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $48.27 / $73.02 / $140.15	Professional	26	$48.27	$73.02	$140.15
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $263.52 / $380.33 / $665.56	Professional	TC	$263.52	$380.33	$665.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $335.51 / $490.96	Professional		$42.05	$335.51	$490.96
United Facility/Professional Professional Modifier Low / Median / High Price $229.59 / $401.32 / $725.73	Professional		$229.59	$401.32	$725.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.87 / $59.03 / $170.26	Professional	26	$42.87	$59.03	$170.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $210.30 / $344.97 / $660.35	Professional	TC	$210.30	$344.97	$660.35