Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.05 / $91.88 / $173.27	Facility	26	$54.05	$91.88	$173.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.32 / $417.58 / $747.46	Professional		$328.32	$417.58	$747.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.40 / $57.27 / $114.74	Professional	26	$50.40	$57.27	$114.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.79 / $363.54 / $623.47	Professional	TC	$281.79	$363.54	$623.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $376.62 / $453.69 / $563.02	Professional		$376.62	$453.69	$563.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $62.62 / $73.05	Professional	26	$51.38	$62.62	$73.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.69 / $234.19 / $530.85	Professional		$144.69	$234.19	$530.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.47 / $63.77 / $111.76	Professional	26	$46.47	$63.77	$111.76
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.38 / $157.63 / $455.56	Professional	TC	$93.38	$157.63	$455.56
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $402.16 / $522.80 / $603.24	Professional		$402.16	$522.80	$603.24
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $52.18 / $67.83 / $78.27	Professional	26	$52.18	$67.83	$78.27
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $349.98 / $454.97 / $524.97	Professional	TC	$349.98	$454.97	$524.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.72 / $423.96 / $559.97	Professional		$61.72	$423.96	$559.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.14 / $513.78 / $1,025.64	Professional		$276.14	$513.78	$1,025.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.18 / $76.20 / $135.19	Professional	26	$52.18	$76.20	$135.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $198.49 / $440.87 / $880.90	Professional	TC	$198.49	$440.87	$880.90
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $193.00 / $478.57 / $765.21	Professional		$193.00	$478.57	$765.21
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $53.23 / $75.76 / $119.00	Professional	26	$53.23	$75.76	$119.00
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $240.60 / $440.87 / $699.70	Professional	TC	$240.60	$440.87	$699.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.05 / $366.80 / $581.96	Professional		$63.05	$366.80	$581.96
United Facility/Professional Professional Modifier Low / Median / High Price $259.99 / $483.32 / $909.08	Professional		$259.99	$483.32	$909.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.99 / $71.97 / $121.36	Professional	26	$47.99	$71.97	$121.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.97 / $413.78 / $741.54	Professional	TC	$194.97	$413.78	$741.54