Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.31 / $155.97 / $405.20	Facility		$53.31	$155.97	$405.20
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.09 / $18.37 / $174.93	Facility	26	$10.09	$18.37	$174.93
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.26 / $204.92 / $381.16	Facility	TC	$32.26	$204.92	$381.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $37.79 / $129.60	Professional		$27.74	$37.79	$129.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.24 / $35.29	Professional	26	$9.77	$14.24	$35.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $26.00 / $47.05	Professional	TC	$18.32	$26.00	$47.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.32 / $26.49 / $60.00	Professional		$24.32	$26.49	$60.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.73 / $12.04 / $18.05	Professional	26	$7.73	$12.04	$18.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.43 / $21.08 / $32.04	Professional	TC	$17.43	$21.08	$32.04
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 $28.45 / $35.11 / $57.92	Professional		$28.45	$35.11	$57.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.54 / $12.55 / $21.63	Professional	26	$10.54	$12.55	$21.63
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $22.32 / $37.28	Professional	TC	$18.00	$22.32	$37.28
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $39.61 / $39.92	Professional		$35.95	$39.61	$39.92
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $11.58 / $12.75 / $12.85	Professional	26	$11.58	$12.75	$12.85
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $24.39 / $26.87 / $27.08	Professional	TC	$24.39	$26.87	$27.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.79 / $24.80 / $41.13	Facility		$10.79	$24.80	$41.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.79 / $25.93 / $42.66	Professional		$10.79	$25.93	$42.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.65 / $173.99 / $268.55	Facility		$37.65	$173.99	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $12.86	Facility	26	$11.95	$11.95	$12.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $22.44 / $26.10 / $26.10	Facility	TC	$22.44	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.43 / $40.29 / $69.95	Professional		$27.43	$40.29	$69.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.90 / $13.86 / $23.38	Professional	26	$8.90	$13.86	$23.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.36 / $26.28 / $48.74	Professional	TC	$18.36	$26.28	$48.74
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $123.09 / $222.45 / $384.81	Facility		$123.09	$222.45	$384.81
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $12.86	Facility	26	$11.95	$11.95	$12.86
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $26.10 / $255.02 / $360.27	Facility	TC	$26.10	$255.02	$360.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $40.22 / $87.74	Professional		$27.00	$40.22	$87.74
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.17 / $16.25 / $31.67	Professional	26	$10.17	$16.25	$31.67
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $18.94 / $26.87 / $49.00	Professional	TC	$18.94	$26.87	$49.00
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 $25.56 / $35.86 / $62.20	Professional		$25.56	$35.86	$62.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.13 / $12.87 / $25.88	Professional	26	$9.13	$12.87	$25.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.94 / $23.77 / $48.42	Professional	TC	$16.94	$23.77	$48.42