Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.34 / $226.67 / $6,128.09	Facility	26	$133.34	$226.67	$6,128.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $554.14 / $720.28 / $1,247.20	Professional		$554.14	$720.28	$1,247.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.16 / $133.34 / $288.02	Professional	26	$110.16	$133.34	$288.02
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $273.83 / $308.69 / $400.49	Professional	52	$273.83	$308.69	$400.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $441.72 / $559.03 / $959.18	Professional	TC	$441.72	$559.03	$959.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $523.05 / $523.05 / $607.87	Professional		$523.05	$523.05	$607.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $102.08 / $142.69 / $170.14	Professional	26	$102.08	$142.69	$170.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $552.38 / $715.53 / $1,202.84	Professional		$552.38	$715.53	$1,202.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $106.00 / $137.55 / $242.13	Professional	26	$106.00	$137.55	$242.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $442.45 / $580.72 / $977.44	Professional	TC	$442.45	$580.72	$977.44
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $562.42 / $562.42 / $894.26	Professional		$562.42	$562.42	$894.26
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $109.77 / $109.77 / $174.53	Professional	26	$109.77	$109.77	$174.53
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $452.67 / $452.67 / $719.75	Professional	TC	$452.67	$452.67	$719.75
CareSource Facility/Professional Professional Modifier Low / Median / High Price $130.18 / $563.89 / $766.80	Professional		$130.18	$563.89	$766.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.97 / $133.97 / $133.97	Facility	26	$133.97	$133.97	$133.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $552.40 / $868.59 / $1,527.18	Professional		$552.40	$868.59	$1,527.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.77 / $170.14 / $320.44	Professional	26	$109.77	$170.14	$320.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $443.44 / $679.00 / $1,223.72	Professional	TC	$443.44	$679.00	$1,223.72
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $133.97 / $133.97 / $133.97	Facility	26	$133.97	$133.97	$133.97
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $461.56 / $787.40 / $1,246.32	Professional		$461.56	$787.40	$1,246.32
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $109.77 / $170.14 / $351.50	Professional	26	$109.77	$170.14	$351.50
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $439.93 / $656.36 / $1,064.82	Professional	TC	$439.93	$656.36	$1,064.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $127.42 / $486.21 / $794.56	Professional		$127.42	$486.21	$794.56
United Facility/Professional Professional Modifier Low / Median / High Price $540.36 / $783.44 / $1,242.20	Professional		$540.36	$783.44	$1,242.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.33 / $162.65 / $277.95	Professional	26	$108.33	$162.65	$277.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $428.55 / $625.13 / $964.86	Professional	TC	$428.55	$625.13	$964.86