Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.28 / $202.15 / $588.58	Facility		$39.28	$202.15	$588.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.16 / $13.50 / $31.54	Facility	26	$8.16	$13.50	$31.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.61 / $209.62 / $432.93	Facility	TC	$22.61	$209.62	$432.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $23.96 / $50.80	Professional		$17.78	$23.96	$50.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $9.63 / $24.08	Professional	26	$8.08	$9.63	$24.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.69 / $15.81 / $29.99	Professional	TC	$9.69	$15.81	$29.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $20.53 / $42.26	Professional		$17.98	$20.53	$42.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $9.68 / $15.12	Professional	26	$6.45	$9.68	$15.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $13.06 / $13.06 / $13.06	Professional	TC	$13.06	$13.06	$13.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $182.82 / $193.56 / $220.94	Facility		$182.82	$193.56	$220.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.46 / $23.77 / $39.61	Professional		$18.46	$23.77	$39.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $10.18 / $18.13	Professional	26	$8.73	$10.18	$18.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.73 / $12.92 / $22.91	Professional	TC	$9.73	$12.92	$22.91
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $27.82 / $30.65 / $43.15	Professional		$27.82	$30.65	$43.15
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $10.69 / $15.04	Professional	26	$9.69	$10.69	$15.04
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $18.12 / $19.97 / $28.11	Professional	TC	$18.12	$19.97	$28.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.03 / $18.43 / $31.83	Facility		$9.03	$18.43	$31.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.03 / $19.21 / $33.01	Professional		$9.03	$19.21	$33.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.01 / $173.99 / $268.55	Facility		$29.01	$173.99	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $10.74	Facility	26	$9.67	$9.67	$10.74
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.98 / $19.39 / $19.39	Facility	TC	$16.98	$19.39	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.04 / $28.30 / $53.37	Professional		$20.04	$28.30	$53.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $11.62 / $19.55	Professional	26	$7.36	$11.62	$19.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.43 / $17.25 / $34.40	Professional	TC	$11.43	$17.25	$34.40
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $109.08 / $191.80 / $346.38	Facility		$109.08	$191.80	$346.38
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $10.74	Facility	26	$9.67	$9.67	$10.74
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $19.39 / $219.14 / $292.39	Facility	TC	$19.39	$219.14	$292.39
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $28.30 / $54.90	Professional		$19.00	$28.30	$54.90
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $13.15 / $24.44	Professional	26	$8.38	$13.15	$24.44
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $12.22 / $18.18 / $32.26	Professional	TC	$12.22	$18.18	$32.26
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 Professional Modifier Low / Median / High Price $18.66 / $27.10 / $51.21	Professional		$18.66	$27.10	$51.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $10.54 / $18.23	Professional	26	$7.50	$10.54	$18.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.72 / $16.04 / $29.88	Professional	TC	$9.72	$16.04	$29.88