Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $149.16 / $253.58 / $478.85	Facility	26	$149.16	$253.58	$478.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $224.29 / $254.68 / $443.63	Professional		$224.29	$254.68	$443.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.82 / $155.52 / $278.24	Professional	26	$138.82	$155.52	$278.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.68 / $99.65 / $152.46	Professional	TC	$84.68	$99.65	$152.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.46 / $223.16 / $345.90	Professional		$199.46	$223.16	$345.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $135.12 / $188.88 / $203.41	Professional	26	$135.12	$188.88	$203.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.73 / $267.79 / $426.03	Professional		$199.73	$267.79	$426.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $119.00 / $161.01 / $255.91	Professional	26	$119.00	$161.01	$255.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.72 / $102.76 / $168.54	Professional	TC	$80.72	$102.76	$168.54
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $290.11 / $290.11 / $290.11	Professional		$290.11	$290.11	$290.11
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $188.88 / $188.88 / $188.88	Professional	26	$188.88	$188.88	$188.88
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $101.23 / $101.23 / $101.23	Professional	TC	$101.23	$101.23	$101.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.22 / $188.88 / $305.27	Professional		$90.22	$188.88	$305.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $176.41 / $176.41 / $176.41	Facility	26	$176.41	$176.41	$176.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.95 / $314.88 / $599.91	Professional		$169.95	$314.88	$599.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $145.29 / $212.38 / $420.64	Professional	26	$145.29	$212.38	$420.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.47 / $125.76 / $241.88	Professional	TC	$81.47	$125.76	$241.88
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $176.41 / $176.41 / $176.41	Facility	26	$176.41	$176.41	$176.41
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $224.56 / $328.28 / $474.35	Professional		$224.56	$328.28	$474.35
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $145.29 / $212.38 / $346.19	Professional	26	$145.29	$212.38	$346.19
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $80.37 / $120.70 / $212.74	Professional	TC	$80.37	$120.70	$212.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $90.17 / $152.23 / $279.38	Professional		$90.17	$152.23	$279.38
United Facility/Professional Professional Modifier Low / Median / High Price $225.53 / $322.94 / $541.24	Professional		$225.53	$322.94	$541.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $139.27 / $206.07 / $355.77	Professional	26	$139.27	$206.07	$355.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.19 / $123.52 / $199.75	Professional	TC	$84.19	$123.52	$199.75