Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.02 / $130.93 / $247.81	Facility	26	$77.02	$130.93	$247.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $151.59 / $256.97	Professional		$130.08	$151.59	$256.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.45 / $78.34 / $132.08	Professional	26	$71.45	$78.34	$132.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $74.64 / $129.97	Professional	TC	$55.03	$74.64	$129.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $149.44 / $149.44 / $149.44	Professional		$149.44	$149.44	$149.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.86 / $77.86 / $77.86	Professional	26	$77.86	$77.86	$77.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.74 / $142.72 / $227.35	Professional		$99.74	$142.72	$227.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.52 / $90.34 / $145.29	Professional	26	$66.52	$90.34	$145.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.13 / $44.51 / $94.32	Professional	TC	$27.13	$44.51	$94.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.72 / $100.59 / $190.15	Professional		$73.72	$100.59	$190.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.04 / $91.04 / $91.04	Facility	26	$91.04	$91.04	$91.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.06 / $180.37 / $325.68	Professional		$116.06	$180.37	$325.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.51 / $109.53 / $193.38	Professional	26	$74.51	$109.53	$193.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.31 / $87.08 / $195.92	Professional	TC	$46.31	$87.08	$195.92
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $91.04 / $91.04 / $91.04	Facility	26	$91.04	$91.04	$91.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $132.78 / $183.11 / $298.19	Professional		$132.78	$183.11	$298.19
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $74.51 / $108.40 / $165.92	Professional	26	$74.51	$108.40	$165.92
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $54.26 / $87.08 / $152.46	Professional	TC	$54.26	$87.08	$152.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.11 / $108.55 / $199.02	Professional		$60.11	$108.55	$199.02
United Facility/Professional Professional Modifier Low / Median / High Price $128.13 / $198.48 / $352.05	Professional		$128.13	$198.48	$352.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.69 / $103.98 / $173.64	Professional	26	$70.69	$103.98	$173.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.17 / $97.84 / $173.43	Professional	TC	$41.17	$97.84	$173.43