Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.67 / $291.17 / $1,153.07	Professional		$263.67	$291.17	$1,153.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.84 / $50.63 / $178.30	Professional	26	$38.84	$50.63	$178.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.66 / $242.94 / $849.46	Professional	TC	$120.66	$242.94	$849.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $44.38 / $100.61	Professional	26	$29.59	$44.38	$100.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.04 / $202.44 / $450.97	Professional		$167.04	$202.44	$450.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.78 / $34.54 / $99.63	Professional	26	$26.78	$34.54	$99.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $140.26 / $169.71 / $374.03	Professional	TC	$140.26	$169.71	$374.03
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $267.11 / $267.11 / $279.25	Professional		$267.11	$267.11	$279.25
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $45.56 / $45.56 / $47.63	Professional	26	$45.56	$45.56	$47.63
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $221.54 / $221.54 / $231.61	Professional	TC	$221.54	$221.54	$231.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.17 / $345.26 / $571.30	Professional		$59.17	$345.26	$571.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.07 / $265.17 / $572.38	Professional		$163.07	$265.17	$572.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $59.17 / $107.98	Professional	26	$29.59	$59.17	$107.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.09 / $181.67 / $460.36	Professional	TC	$111.09	$181.67	$460.36
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $120.80 / $265.17 / $572.38	Professional		$120.80	$265.17	$572.38
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $64.28 / $129.27	Professional	26	$29.59	$64.28	$129.27
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $111.09 / $225.42 / $460.36	Professional	TC	$111.09	$225.42	$460.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.44 / $350.83 / $544.04	Professional		$40.44	$350.83	$544.04
United Facility/Professional Professional Modifier Low / Median / High Price $201.44 / $381.27 / $648.16	Professional		$201.44	$381.27	$648.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.68 / $66.14 / $112.45	Professional	26	$39.68	$66.14	$112.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $136.91 / $307.92 / $516.42	Professional	TC	$136.91	$307.92	$516.42