Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.79 / $155.13 / $389.84	Facility		$47.79	$155.13	$389.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.09 / $14.13 / $36.97	Facility	26	$10.09	$14.13	$36.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.80 / $34.09 / $64.66	Professional		$17.80	$34.09	$64.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $14.12 / $36.97	Professional	26	$9.41	$14.12	$36.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $25.17 / $47.28	Professional	TC	$19.76	$25.17	$47.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.37 / $33.08 / $38.10	Professional		$27.37	$33.08	$38.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $10.59 / $17.68	Professional	26	$8.08	$10.59	$17.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.84 / $22.84 / $22.84	Professional	TC	$22.84	$22.84	$22.84
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 $28.90 / $36.74 / $61.92	Professional		$28.90	$36.74	$61.92
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.20 / $13.24 / $23.08	Professional	26	$11.20	$13.24	$23.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.70 / $23.05 / $39.17	Professional	TC	$17.70	$23.05	$39.17
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $39.09 / $39.09 / $39.09	Professional		$39.09	$39.09	$39.09
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $11.92 / $11.92 / $11.92	Professional	26	$11.92	$11.92	$11.92
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $27.16 / $27.16 / $27.16	Professional	TC	$27.16	$27.16	$27.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.11 / $27.62 / $44.73	Facility		$11.11	$27.62	$44.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.11 / $28.90 / $46.38	Professional		$11.11	$28.90	$46.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $166.60 / $268.55	Facility		$41.01	$166.60	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $13.25	Facility	26	$11.95	$11.95	$13.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.47 / $43.75 / $78.84	Professional		$29.47	$43.75	$78.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.13 / $14.23 / $24.24	Professional	26	$9.13	$14.23	$24.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.37 / $29.18 / $53.94	Professional	TC	$20.37	$29.18	$53.94
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $62.03 / $196.70 / $448.25	Facility		$62.03	$196.70	$448.25
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $13.25	Facility	26	$11.95	$11.95	$13.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $28.74 / $43.06 / $71.50	Professional		$28.74	$43.06	$71.50
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $14.84 / $29.27	Professional	26	$10.10	$14.84	$29.27
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $29.64 / $51.57	Professional	TC	$21.01	$29.64	$51.57
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 $27.79 / $38.97 / $67.39	Professional		$27.79	$38.97	$67.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $12.97 / $24.36	Professional	26	$9.59	$12.97	$24.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.51 / $24.96 / $44.87	Professional	TC	$17.51	$24.96	$44.87