Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.36 / $121.17 / $213.13	Facility	26	$72.36	$121.17	$213.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.54 / $229.24 / $645.26	Professional		$190.54	$229.24	$645.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.83 / $83.86 / $311.94	Professional	26	$70.83	$83.86	$311.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $118.17 / $144.16 / $226.88	Professional	TC	$118.17	$144.16	$226.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.41 / $76.66 / $99.03	Professional	26	$59.41	$76.66	$99.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.37 / $201.37 / $358.79	Professional		$149.37	$201.37	$358.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.89 / $83.23 / $155.04	Professional	26	$63.89	$83.23	$155.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.47 / $116.85 / $202.34	Professional	TC	$83.47	$116.85	$202.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.28 / $132.26 / $225.47	Professional		$70.28	$132.26	$225.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.91 / $246.79 / $406.24	Professional		$173.91	$246.79	$406.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.15 / $96.70 / $146.33	Professional	26	$68.15	$96.70	$146.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.58 / $153.63 / $260.12	Professional	TC	$100.58	$153.63	$260.12
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $161.61 / $237.43 / $378.19	Professional		$161.61	$237.43	$378.19
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $69.28 / $96.81 / $145.38	Professional	26	$69.28	$96.81	$145.38
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $103.37 / $153.63 / $248.83	Professional	TC	$103.37	$153.63	$248.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $64.33 / $110.15 / $210.13	Professional		$64.33	$110.15	$210.13
United Facility/Professional Professional Modifier Low / Median / High Price $160.56 / $229.87 / $394.02	Professional		$160.56	$229.87	$394.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.42 / $88.57 / $145.69	Professional	26	$63.42	$88.57	$145.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.70 / $143.46 / $225.21	Professional	TC	$96.70	$143.46	$225.21