Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.09 / $674.93 / $719.71	Facility		$99.09	$674.93	$719.71
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.23 / $42.23 / $42.23	Facility	26	$42.23	$42.23	$42.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.00 / $124.40 / $207.11	Professional		$107.00	$124.40	$207.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $22.73 / $33.99	Professional	26	$11.77	$22.73	$33.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.88 / $102.98 / $172.85	Professional	TC	$92.88	$102.98	$172.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.11 / $23.11 / $36.06	Professional	26	$23.11	$23.11	$36.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.28 / $125.20 / $192.32	Professional		$91.28	$125.20	$192.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.10 / $15.98 / $27.62	Professional	26	$11.10	$15.98	$27.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.84 / $108.03 / $163.06	Professional	TC	$79.84	$108.03	$163.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $22.19 / $126.80 / $168.64	Facility		$22.19	$126.80	$168.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.93 / $118.77 / $162.15	Professional		$23.93	$118.77	$162.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $214.04 / $326.23	Facility		$147.68	$214.04	$326.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.16 / $189.12 / $330.42	Professional		$133.16	$189.12	$330.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.22 / $25.02 / $45.77	Professional	26	$15.22	$25.02	$45.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.34 / $161.96 / $288.30	Professional	TC	$111.34	$161.96	$288.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $214.04 / $326.23	Facility		$147.68	$214.04	$326.23
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $134.47 / $189.93 / $315.00	Professional		$134.47	$189.93	$315.00
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $17.25 / $25.89 / $45.68	Professional	26	$17.25	$25.89	$45.68
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $113.37 / $161.96 / $288.30	Professional	TC	$113.37	$161.96	$288.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $109.03 / $171.39	Professional		$35.74	$109.03	$171.39
United Facility/Professional Professional Modifier Low / Median / High Price $125.92 / $174.27 / $298.32	Professional		$125.92	$174.27	$298.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.16 / $25.41 / $48.28	Professional	26	$14.16	$25.41	$48.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.24 / $146.09 / $248.10	Professional	TC	$106.24	$146.09	$248.10