Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $309.57 / $489.80 / $995.05	Facility	26	$309.57	$489.80	$995.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,049.33 / $1,211.85 / $2,016.08	Professional		$1,049.33	$1,211.85	$2,016.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $286.20 / $355.33 / $641.38	Professional	26	$286.20	$355.33	$641.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $739.76 / $850.72 / $1,389.78	Professional	TC	$739.76	$850.72	$1,389.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $327.67 / $354.98 / $382.28	Professional	26	$327.67	$354.98	$382.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $896.14 / $1,184.93 / $2,892.47	Professional		$896.14	$1,184.93	$2,892.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $307.11 / $399.52 / $680.78	Professional	26	$307.11	$399.52	$680.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $589.03 / $780.77 / $1,032.49	Professional	TC	$589.03	$780.77	$1,032.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $354.98 / $812.01 / $1,478.40	Professional		$354.98	$812.01	$1,478.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $995.80 / $1,391.40 / $2,000.58	Professional		$995.80	$1,391.40	$2,000.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $300.36 / $417.09 / $605.89	Professional	26	$300.36	$417.09	$605.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $700.12 / $965.60 / $1,417.25	Professional	TC	$700.12	$965.60	$1,417.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $897.68 / $1,329.57 / $1,914.68	Professional		$897.68	$1,329.57	$1,914.68
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $295.68 / $400.37 / $605.89	Professional	26	$295.68	$400.37	$605.89
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $700.12 / $943.19 / $1,390.00	Professional	TC	$700.12	$943.19	$1,390.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $311.27 / $745.70 / $1,278.92	Professional		$311.27	$745.70	$1,278.92
United Facility/Professional Professional Modifier Low / Median / High Price $995.34 / $1,341.34 / $2,082.96	Professional		$995.34	$1,341.34	$2,082.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $294.64 / $411.09 / $618.50	Professional	26	$294.64	$411.09	$618.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $687.43 / $907.88 / $1,333.11	Professional	TC	$687.43	$907.88	$1,333.11