Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.52 / $62.08 / $123.07	Facility	26	$36.52	$62.08	$123.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.33 / $277.89 / $446.26	Professional		$228.33	$277.89	$446.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.67 / $40.32 / $71.00	Professional	26	$35.67	$40.32	$71.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.82 / $236.99 / $363.88	Professional	TC	$191.82	$236.99	$363.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $205.01 / $205.01 / $215.15	Professional		$205.01	$205.01	$215.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.59 / $35.46 / $46.94	Professional	26	$33.59	$35.46	$46.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.93 / $278.33 / $464.14	Professional		$213.93	$278.33	$464.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.32 / $43.32 / $72.30	Professional	26	$33.32	$43.32	$72.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $180.60 / $235.86 / $391.83	Professional	TC	$180.60	$235.86	$391.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $202.76 / $275.56	Professional		$39.72	$202.76	$275.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.62 / $327.12 / $482.01	Professional		$229.62	$327.12	$482.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.64 / $50.58 / $76.20	Professional	26	$36.64	$50.58	$76.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.31 / $275.20 / $400.86	Professional	TC	$189.31	$275.20	$400.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $231.47 / $326.63 / $467.42	Professional		$231.47	$326.63	$467.42
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $37.84 / $51.13 / $74.12	Professional	26	$37.84	$51.13	$74.12
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $193.55 / $275.20 / $394.91	Professional	TC	$193.55	$275.20	$394.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.44 / $217.48 / $328.47	Professional		$40.44	$217.48	$328.47
United Facility/Professional Professional Modifier Low / Median / High Price $217.40 / $301.94 / $543.50	Professional		$217.40	$301.94	$543.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.46 / $49.31 / $83.16	Professional	26	$33.46	$49.31	$83.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.92 / $255.10 / $450.67	Professional	TC	$181.92	$255.10	$450.67