Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.71 / $176.28 / $352.55	Facility		$46.71	$176.28	$352.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $12.10 / $41.49	Facility	26	$8.46	$12.10	$41.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.39 / $81.43 / $665.52	Facility	TC	$30.39	$81.43	$665.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.03 / $37.21 / $70.73	Professional		$30.03	$37.21	$70.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $11.43 / $38.71	Professional	26	$8.22	$11.43	$38.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.09 / $26.11 / $51.26	Professional	TC	$22.09	$26.11	$51.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.66 / $26.82 / $59.38	Professional		$26.66	$26.82	$59.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $8.26 / $12.39	Professional	26	$6.45	$8.26	$12.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $246.06 / $260.52 / $297.37	Facility		$246.06	$260.52	$297.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.50 / $38.31 / $66.48	Professional		$29.50	$38.31	$66.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.65 / $13.32 / $25.07	Professional	26	$10.65	$13.32	$25.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.20 / $24.47 / $41.82	Professional	TC	$17.20	$24.47	$41.82
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $38.26 / $38.26 / $38.26	Professional		$38.26	$38.26	$38.26
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $9.69 / $9.69	Professional	26	$9.69	$9.69	$9.69
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $28.56 / $28.56 / $28.56	Professional	TC	$28.56	$28.56	$28.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.03 / $29.04 / $43.77	Facility		$9.03	$29.04	$43.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.03 / $30.39 / $45.39	Professional		$9.03	$30.39	$45.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.44 / $218.77 / $324.91	Facility		$45.44	$218.77	$324.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $14.89	Facility	26	$10.01	$10.01	$14.89
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.50 / $30.58 / $30.58	Facility	TC	$27.50	$30.58	$30.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.98 / $45.39 / $79.09	Professional		$30.98	$45.39	$79.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $13.17 / $22.82	Professional	26	$8.22	$13.17	$22.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.61 / $32.18 / $57.11	Professional	TC	$21.61	$32.18	$57.11
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $66.38 / $218.77 / $405.20	Facility		$66.38	$218.77	$405.20
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $14.89	Facility	26	$10.01	$10.01	$14.89
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $27.50 / $27.50 / $30.58	Facility	TC	$27.50	$27.50	$30.58
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $31.69 / $45.39 / $77.26	Professional		$31.69	$45.39	$77.26
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $8.65 / $13.26 / $23.84	Professional	26	$8.65	$13.26	$23.84
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $22.32 / $32.28 / $54.21	Professional	TC	$22.32	$32.28	$54.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $36.24 / $51.07	Professional		$26.52	$36.24	$51.07
United Facility/Professional Facility Modifier Low / Median / High Price $213.48 / $213.48 / $249.25	Facility		$213.48	$213.48	$249.25
United Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $39.39 / $68.56	Professional		$28.91	$39.39	$68.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.43 / $12.22 / $20.94	Professional	26	$8.43	$12.22	$20.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $26.68 / $46.85	Professional	TC	$19.73	$26.68	$46.85