Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.45 / $108.56 / $190.94	Facility	26	$64.45	$108.56	$190.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.53 / $264.23 / $1,169.00	Professional		$215.53	$264.23	$1,169.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.78 / $71.45 / $334.43	Professional	26	$62.78	$71.45	$334.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.75 / $166.43 / $432.10	Professional	TC	$152.75	$166.43	$432.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $271.73 / $271.73 / $271.73	Professional		$271.73	$271.73	$271.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.40 / $48.40 / $79.72	Professional	26	$48.40	$48.40	$79.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.07 / $257.24 / $432.88	Professional		$183.07	$257.24	$432.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.42 / $77.25 / $139.50	Professional	26	$59.42	$77.25	$139.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.19 / $178.04 / $294.63	Professional	TC	$123.19	$178.04	$294.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $62.63 / $171.54 / $265.39	Professional		$62.63	$171.54	$265.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.49 / $285.88 / $434.75	Professional		$213.49	$285.88	$434.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.72 / $85.41 / $127.55	Professional	26	$61.72	$85.41	$127.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $150.86 / $203.32 / $307.70	Professional	TC	$150.86	$203.32	$307.70
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $203.79 / $284.29 / $414.76	Professional		$203.79	$284.29	$414.76
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $62.08 / $86.61 / $125.37	Professional	26	$62.08	$86.61	$125.37
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $150.86 / $203.15 / $296.58	Professional	TC	$150.86	$203.15	$296.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $182.53 / $277.26	Professional		$40.54	$182.53	$277.26
United Facility/Professional Professional Modifier Low / Median / High Price $199.45 / $265.14 / $449.65	Professional		$199.45	$265.14	$449.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.60 / $78.09 / $130.24	Professional	26	$57.60	$78.09	$130.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.72 / $192.02 / $321.68	Professional	TC	$137.72	$192.02	$321.68