Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.14 / $196.24 / $501.10	Facility		$56.14	$196.24	$501.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.40 / $14.87 / $36.97	Facility	26	$10.40	$14.87	$36.97
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.61 / $247.16 / $391.04	Facility	TC	$34.61	$247.16	$391.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $45.01 / $88.72	Professional		$35.10	$45.01	$88.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $14.36 / $33.90	Professional	26	$9.98	$14.36	$33.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.86 / $31.04 / $56.01	Professional	TC	$24.86	$31.04	$56.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.62 / $30.41 / $55.46	Professional		$28.62	$30.41	$55.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.97 / $13.13 / $17.68	Professional	26	$7.97	$13.13	$17.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.71 / $26.19 / $39.79	Professional	TC	$22.71	$26.19	$39.79
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 $30.50 / $39.52 / $65.73	Professional		$30.50	$39.52	$65.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $13.49 / $24.23	Professional	26	$11.28	$13.49	$24.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.10 / $25.90 / $42.93	Professional	TC	$19.10	$25.90	$42.93
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $42.22 / $42.22 / $65.48	Professional		$42.22	$42.22	$65.48
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $11.92 / $11.92 / $18.48	Professional	26	$11.92	$11.92	$18.48
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $30.30 / $30.30 / $46.99	Professional	TC	$30.30	$30.30	$46.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $11.11 / $30.86 / $48.30	Facility		$11.11	$30.86	$48.30
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.11 / $32.26 / $50.09	Professional		$11.11	$32.26	$50.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.36 / $166.60 / $268.55	Facility		$44.36	$166.60	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $13.25	Facility	26	$12.30	$12.30	$13.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.50 / $32.44 / $32.44	Facility	TC	$27.50	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.90 / $47.55 / $85.03	Professional		$31.90	$47.55	$85.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $14.31 / $24.30	Professional	26	$9.59	$14.31	$24.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.82 / $33.10 / $59.44	Professional	TC	$22.82	$33.10	$59.44
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $85.14 / $224.92 / $425.74	Facility		$85.14	$224.92	$425.74
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $13.25	Facility	26	$12.30	$12.30	$13.25
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $27.50 / $237.14 / $363.76	Facility	TC	$27.50	$237.14	$363.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $31.41 / $47.02 / $85.32	Professional		$31.41	$47.02	$85.32
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.22 / $16.63 / $30.96	Professional	26	$10.22	$16.63	$30.96
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $23.52 / $33.90 / $57.51	Professional	TC	$23.52	$33.90	$57.51
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 $30.72 / $41.71 / $72.54	Professional		$30.72	$41.71	$72.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $12.72 / $22.08	Professional	26	$9.27	$12.72	$22.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.70 / $28.11 / $49.68	Professional	TC	$19.70	$28.11	$49.68