Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.14 / $75.03 / $141.13	Facility	26	$44.14	$75.03	$141.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $252.59 / $479.16	Professional		$206.63	$252.59	$479.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.42 / $48.88 / $89.02	Professional	26	$43.42	$48.88	$89.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $208.45 / $395.42	Professional	TC	$162.49	$208.45	$395.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.82 / $34.54 / $66.27	Professional	26	$24.82	$34.54	$66.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.56 / $238.45 / $401.88	Professional		$167.56	$238.45	$401.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $53.45 / $92.12	Professional	26	$40.29	$53.45	$92.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $127.28 / $183.59 / $309.01	Professional	TC	$127.28	$183.59	$309.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.46 / $205.63 / $252.10	Professional		$46.46	$205.63	$252.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.68 / $340.31 / $578.04	Professional		$247.68	$340.31	$578.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.49 / $59.88 / $89.42	Professional	26	$43.49	$59.88	$89.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.77 / $287.86 / $496.97	Professional	TC	$201.77	$287.86	$496.97
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $244.08 / $335.84 / $553.00	Professional		$244.08	$335.84	$553.00
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $44.35 / $61.65 / $90.38	Professional	26	$44.35	$61.65	$90.38
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $202.44 / $288.45 / $478.44	Professional	TC	$202.44	$288.45	$478.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.51 / $230.92 / $362.50	Professional		$40.51	$230.92	$362.50
United Facility/Professional Professional Modifier Low / Median / High Price $223.42 / $322.13 / $569.26	Professional		$223.42	$322.13	$569.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.90 / $57.02 / $101.09	Professional	26	$40.90	$57.02	$101.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $189.99 / $283.49 / $464.68	Professional	TC	$189.99	$283.49	$464.68