Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.53 / $148.10 / $260.49	Facility	26	$81.53	$148.10	$260.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $335.55 / $408.64 / $700.81	Professional		$335.55	$408.64	$700.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.66 / $87.51 / $160.82	Professional	26	$76.66	$87.51	$160.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.72 / $326.23 / $560.99	Professional	TC	$263.72	$326.23	$560.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $397.93 / $397.93 / $397.93	Professional		$397.93	$397.93	$397.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.37 / $98.62 / $122.28	Professional	26	$73.37	$98.62	$122.28
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $232.55 / $334.80 / $575.08	Professional		$232.55	$334.80	$575.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.42 / $96.46 / $170.41	Professional	26	$72.42	$96.46	$170.41
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $139.60 / $209.03 / $423.65	Professional	TC	$139.60	$209.03	$423.65
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $515.72 / $515.72 / $595.07	Professional		$515.72	$515.72	$595.07
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $102.56 / $102.56 / $118.34	Professional	26	$102.56	$102.56	$118.34
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $413.17 / $413.17 / $476.73	Professional	TC	$413.17	$413.17	$476.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $86.78 / $349.60 / $495.89	Professional		$86.78	$349.60	$495.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.06 / $515.73 / $972.34	Professional		$326.06	$515.73	$972.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.89 / $118.22 / $207.31	Professional	26	$78.89	$118.22	$207.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $240.43 / $409.99 / $765.04	Professional	TC	$240.43	$409.99	$765.04
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $309.63 / $497.24 / $782.64	Professional		$309.63	$497.24	$782.64
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $78.89 / $115.96 / $166.05	Professional	26	$78.89	$115.96	$166.05
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $254.62 / $411.70 / $620.57	Professional	TC	$254.62	$411.70	$620.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.67 / $356.21 / $584.20	Professional		$94.67	$356.21	$584.20
United Facility/Professional Professional Modifier Low / Median / High Price $305.70 / $470.89 / $820.89	Professional		$305.70	$470.89	$820.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.30 / $107.80 / $185.82	Professional	26	$74.30	$107.80	$185.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $238.69 / $389.25 / $635.07	Professional	TC	$238.69	$389.25	$635.07