Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.86 / $174.65 / $310.14	Facility	26	$96.86	$174.65	$310.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $238.84 / $279.04 / $419.98	Professional		$238.84	$279.04	$419.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.34 / $96.86 / $130.76	Professional	26	$84.34	$96.86	$130.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.69 / $176.35 / $278.31	Professional	TC	$146.69	$176.35	$278.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $281.49 / $281.49 / $281.49	Professional		$281.49	$281.49	$281.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $122.97 / $122.97 / $122.97	Professional	26	$122.97	$122.97	$122.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.22 / $238.50 / $407.80	Professional		$151.22	$238.50	$407.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.37 / $112.54 / $182.56	Professional	26	$83.37	$112.54	$182.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.56 / $83.14 / $243.88	Professional	TC	$56.56	$83.14	$243.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $103.17 / $185.91 / $328.50	Professional		$103.17	$185.91	$328.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.59 / $114.59 / $114.59	Facility	26	$114.59	$114.59	$114.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.74 / $360.82 / $732.69	Professional		$230.74	$360.82	$732.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.79 / $138.01 / $255.05	Professional	26	$93.79	$138.01	$255.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.71 / $228.16 / $464.83	Professional	TC	$113.71	$228.16	$464.83
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $114.59 / $114.59 / $114.59	Facility	26	$114.59	$114.59	$114.59
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $220.50 / $355.57 / $559.05	Professional		$220.50	$355.57	$559.05
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $93.79 / $136.22 / $193.91	Professional	26	$93.79	$136.22	$193.91
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $125.08 / $228.67 / $407.01	Professional	TC	$125.08	$228.67	$407.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $94.67 / $201.25 / $362.50	Professional		$94.67	$201.25	$362.50
United Facility/Professional Professional Modifier Low / Median / High Price $222.10 / $330.90 / $589.08	Professional		$222.10	$330.90	$589.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.17 / $130.38 / $231.01	Professional	26	$88.17	$130.38	$231.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.91 / $207.61 / $361.87	Professional	TC	$131.91	$207.61	$361.87