Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.95 / $169.91 / $322.20	Facility	26	$99.95	$169.91	$322.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.28 / $188.93 / $320.33	Professional		$162.28	$188.93	$320.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.61 / $104.52 / $193.78	Professional	26	$93.61	$104.52	$193.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.54 / $79.31 / $121.40	Professional	TC	$65.54	$79.31	$121.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.88 / $182.86 / $246.47	Professional		$147.88	$182.86	$246.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $90.29 / $121.36 / $150.49	Professional	26	$90.29	$121.36	$150.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.87 / $189.27 / $300.49	Professional		$140.87	$189.27	$300.49
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.42 / $107.63 / $170.81	Professional	26	$79.42	$107.63	$170.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.45 / $80.43 / $128.31	Professional	TC	$61.45	$80.43	$128.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $71.86 / $126.22 / $217.39	Professional		$71.86	$126.22	$217.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.19 / $118.19 / $118.19	Facility	26	$118.19	$118.19	$118.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.48 / $223.42 / $430.61	Professional		$123.48	$223.42	$430.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.09 / $141.86 / $280.72	Professional	26	$97.09	$141.86	$280.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.02 / $96.36 / $189.51	Professional	TC	$65.02	$96.36	$189.51
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $118.19 / $118.19 / $118.19	Facility	26	$118.19	$118.19	$118.19
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $161.24 / $236.42 / $350.02	Professional		$161.24	$236.42	$350.02
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $95.28 / $141.86 / $289.95	Professional	26	$95.28	$141.86	$289.95
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $63.07 / $94.56 / $161.93	Professional	TC	$63.07	$94.56	$161.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $60.11 / $110.41 / $199.02	Professional		$60.11	$110.41	$199.02
United Facility/Professional Professional Modifier Low / Median / High Price $161.99 / $230.14 / $409.61	Professional		$161.99	$230.14	$409.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $94.20 / $139.52 / $226.41	Professional	26	$94.20	$139.52	$226.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.23 / $99.97 / $162.22	Professional	TC	$70.23	$99.97	$162.22