Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $125.89 / $407.38	Facility		$48.98	$125.89	$407.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $13.80 / $45.71	Facility	26	$10.00	$13.80	$45.71
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.12 / $77.62 / $389.05	Facility	TC	$25.12	$77.62	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $47.86 / $128.82	Professional		$28.18	$47.86	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $14.13 / $43.65	Professional	26	$9.33	$14.13	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $33.11 / $77.62	Professional	TC	$18.62	$33.11	$77.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $26.30 / $45.71	Professional		$20.89	$26.30	$45.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.23 / $17.38	Professional	26	$7.76	$10.23	$17.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $20.89 / $35.48	Professional	TC	$16.22	$20.89	$35.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $213.80 / $223.87	Facility		$190.55	$213.80	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $37.15 / $60.26	Professional		$28.84	$37.15	$60.26
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.49 / $22.39	Professional	26	$10.47	$13.49	$22.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.99 / $38.90	Professional	TC	$18.20	$23.99	$38.90
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $39.81 / $61.66	Professional		$36.31	$39.81	$61.66
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $12.59 / $19.95	Professional	26	$11.48	$12.59	$19.95
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $27.54 / $42.66	Professional	TC	$24.55	$27.54	$42.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $28.18 / $50.12	Facility		$11.75	$28.18	$50.12
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $25.70 / $46.77	Professional		$10.72	$25.70	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $28.18 / $223.87	Facility		$22.39	$28.18	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.51 / $11.75 / $16.98	Facility	26	$2.51	$11.75	$16.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.37 / $25.12 / $36.31	Facility	TC	$5.37	$25.12	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $39.81 / $69.18	Professional		$26.92	$39.81	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.80 / $23.44	Professional	26	$9.33	$13.80	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.30 / $48.98	Professional	TC	$18.20	$26.30	$48.98
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $229.09 / $380.19	Facility		$125.89	$229.09	$380.19
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $2.51 / $11.75 / $16.98	Facility	26	$2.51	$11.75	$16.98
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $5.25 / $34.67 / $331.13	Facility	TC	$5.25	$34.67	$331.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $36.31 / $83.18	Professional		$22.91	$36.31	$83.18
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.45 / $28.84	Professional	26	$9.12	$14.45	$28.84
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.12 / $45.71	Professional	TC	$16.98	$25.12	$45.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $32.36 / $33.11	Professional		$13.80	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
SummaCare Facility/Professional Facility Modifier TC Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	TC	$107.15	$107.15	$107.15
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $72.44	Professional		$32.36	$40.74	$72.44
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.49 / $22.91	Professional	26	$10.72	$13.49	$22.91
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $27.54 / $48.98	Professional	TC	$21.88	$27.54	$48.98
United Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $66.07 / $208.93	Facility		$11.48	$66.07	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $58.88	Professional		$25.70	$33.11	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.02 / $19.95	Professional	26	$8.71	$12.02	$19.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $21.88 / $38.02	Professional	TC	$16.60	$21.88	$38.02