Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.70 / $145.47 / $255.35	Facility	26	$86.70	$145.47	$255.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.32 / $296.70 / $1,013.00	Professional		$238.32	$296.70	$1,013.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.31 / $96.06 / $256.44	Professional	26	$80.31	$96.06	$256.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $151.62 / $170.00 / $287.62	Professional	TC	$151.62	$170.00	$287.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.56 / $193.56 / $291.38	Professional		$193.56	$193.56	$291.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $71.19 / $99.52 / $165.00	Professional	26	$71.19	$99.52	$165.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.69 / $320.64 / $573.63	Professional		$241.69	$320.64	$573.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.09 / $125.45 / $222.84	Professional	26	$92.09	$125.45	$222.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.37 / $195.57 / $352.95	Professional	TC	$151.37	$195.57	$352.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $84.21 / $171.05 / $289.74	Professional		$84.21	$171.05	$289.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $219.01 / $322.60 / $510.40	Professional		$219.01	$322.60	$510.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.00 / $118.62 / $182.83	Professional	26	$83.00	$118.62	$182.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.09 / $196.34 / $312.92	Professional	TC	$140.09	$196.34	$312.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $218.00 / $317.07 / $480.94	Professional		$218.00	$317.07	$480.94
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $83.00 / $118.62 / $178.30	Professional	26	$83.00	$118.62	$178.30
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $139.87 / $195.38 / $302.64	Professional	TC	$139.87	$195.38	$302.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.40 / $155.36 / $294.34	Professional		$96.40	$155.36	$294.34
United Facility/Professional Professional Modifier Low / Median / High Price $206.76 / $292.48 / $457.34	Professional		$206.76	$292.48	$457.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.61 / $106.40 / $173.62	Professional	26	$78.61	$106.40	$173.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.66 / $185.65 / $290.04	Professional	TC	$132.66	$185.65	$290.04