Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.70 / $90.57 / $218.03	Facility	26	$64.70	$90.57	$218.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.64 / $500.12 / $849.36	Professional		$400.64	$500.12	$849.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.28 / $73.54 / $141.53	Professional	26	$64.28	$73.54	$141.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.94 / $422.35 / $712.19	Professional	TC	$335.94	$422.35	$712.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.50 / $82.07 / $116.15	Professional	26	$50.50	$82.07	$116.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $399.26 / $494.52 / $791.94	Professional		$399.26	$494.52	$791.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.40 / $78.22 / $123.10	Professional	26	$61.40	$78.22	$123.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $337.88 / $416.89 / $670.18	Professional	TC	$337.88	$416.89	$670.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $69.44 / $349.00 / $532.14	Professional		$69.44	$349.00	$532.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $403.52 / $618.53 / $1,042.61	Professional		$403.52	$618.53	$1,042.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.28 / $91.99 / $155.31	Professional	26	$66.28	$91.99	$155.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $346.81 / $522.75 / $891.17	Professional	TC	$346.81	$522.75	$891.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $403.52 / $593.00 / $1,001.70	Professional		$403.52	$593.00	$1,001.70
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $66.28 / $95.78 / $173.79	Professional	26	$66.28	$95.78	$173.79
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $348.56 / $501.01 / $851.04	Professional	TC	$348.56	$501.01	$851.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $407.73 / $590.80	Professional		$42.05	$407.73	$590.80
United Facility/Professional Professional Modifier Low / Median / High Price $380.44 / $513.54 / $964.78	Professional		$380.44	$513.54	$964.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.23 / $84.20 / $154.01	Professional	26	$58.23	$84.20	$154.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $322.20 / $437.24 / $777.49	Professional	TC	$322.20	$437.24	$777.49