Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $665.40 / $665.40 / $665.40	Facility	TC	$665.40	$665.40	$665.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.52 / $402.51 / $631.32	Professional		$313.52	$402.51	$631.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $149.78 / $166.75 / $280.97	Professional	26	$149.78	$166.75	$280.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $149.53 / $209.01 / $464.01	Professional	TC	$149.53	$209.01	$464.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.31 / $81.31 / $227.65	Professional	26	$81.31	$81.31	$227.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $383.73 / $649.69 / $1,259.39	Professional		$383.73	$649.69	$1,259.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $132.19 / $204.91 / $408.54	Professional	26	$132.19	$204.91	$408.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $206.99 / $427.60 / $876.75	Professional	TC	$206.99	$427.60	$876.75
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $367.05 / $367.05 / $383.73	Professional		$367.05	$367.05	$383.73
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $178.87 / $178.87 / $187.00	Professional	26	$178.87	$178.87	$187.00
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $188.18 / $188.18 / $196.73	Professional	TC	$188.18	$188.18	$196.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $396.80 / $396.80 / $396.80	Facility		$396.80	$396.80	$396.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $326.16	Professional		$326.16	$326.16	$326.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $153.56	Professional	26	$153.56	$153.56	$153.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $396.80 / $396.80 / $396.80	Facility		$396.80	$396.80	$396.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $326.16	Professional		$326.16	$326.16	$326.16
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $175.61	Professional	26	$153.56	$153.56	$175.61
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $165.31 / $256.65 / $469.33	Professional		$165.31	$256.65	$469.33
United Facility/Professional Professional Modifier Low / Median / High Price $197.89 / $342.55 / $671.82	Professional		$197.89	$342.55	$671.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $108.65 / $181.07 / $307.83	Professional	26	$108.65	$181.07	$307.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.44 / $162.40 / $431.98	Professional	TC	$97.44	$162.40	$431.98