Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.50 / $100.75 / $177.22	Facility	26	$64.50	$100.75	$177.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.65 / $448.55 / $796.80	Professional		$374.65	$448.55	$796.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.15 / $63.71 / $121.35	Professional	26	$52.15	$63.71	$121.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $317.69 / $384.10 / $674.74	Professional	TC	$317.69	$384.10	$674.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $49.40 / $58.43 / $82.34	Professional	26	$49.40	$58.43	$82.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $340.08 / $461.15 / $724.18	Professional		$340.08	$461.15	$724.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.17 / $67.81 / $111.46	Professional	26	$52.17	$67.81	$111.46
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $287.91 / $386.81 / $592.73	Professional	TC	$287.91	$386.81	$592.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.43 / $372.68 / $489.90	Professional		$58.43	$372.68	$489.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.81 / $64.81 / $64.81	Facility	26	$64.81	$64.81	$64.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $351.98 / $568.28 / $1,097.67	Professional		$351.98	$568.28	$1,097.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.12 / $82.86 / $158.62	Professional	26	$53.12	$82.86	$158.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $303.55 / $474.32 / $952.76	Professional	TC	$303.55	$474.32	$952.76
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $64.81 / $64.81 / $64.81	Facility	26	$64.81	$64.81	$64.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $344.12 / $548.69 / $981.47	Professional		$344.12	$548.69	$981.47
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $53.12 / $80.00 / $158.57	Professional	26	$53.12	$80.00	$158.57
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $294.13 / $458.40 / $882.98	Professional	TC	$294.13	$458.40	$882.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.02 / $385.95 / $578.86	Professional		$40.02	$385.95	$578.86
United Facility/Professional Professional Modifier Low / Median / High Price $360.47 / $536.25 / $910.36	Professional		$360.47	$536.25	$910.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.12 / $80.78 / $139.83	Professional	26	$53.12	$80.78	$139.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $307.68 / $451.04 / $780.70	Professional	TC	$307.68	$451.04	$780.70