Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.63 / $150.93 / $453.65	Facility		$47.63	$150.93	$453.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.43 / $13.48 / $36.97	Facility	26	$9.43	$13.48	$36.97
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.94 / $220.90 / $435.22	Facility	TC	$25.94	$220.90	$435.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.32 / $35.47 / $93.78	Professional		$29.32	$35.47	$93.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $12.73 / $33.77	Professional	26	$9.16	$12.73	$33.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.94 / $23.97 / $44.57	Professional	TC	$19.94	$23.97	$44.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.57 / $26.02 / $46.24	Professional		$24.57	$26.02	$46.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $9.60 / $16.03	Professional	26	$7.33	$9.60	$16.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.11 / $21.08 / $32.04	Professional	TC	$17.11	$21.08	$32.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $246.06 / $260.52 / $297.37	Facility		$246.06	$260.52	$297.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.10 / $37.28 / $65.43	Professional		$32.10	$37.28	$65.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $13.30 / $24.23	Professional	26	$10.29	$13.30	$24.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $24.92 / $42.02	Professional	TC	$20.70	$24.92	$42.02
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $35.20 / $35.20 / $35.20	Professional		$35.20	$35.20	$35.20
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.81 / $10.81 / $10.81	Professional	26	$10.81	$10.81	$10.81
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $24.39 / $24.39 / $24.39	Professional	TC	$24.39	$24.39	$24.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.08 / $24.89 / $40.27	Facility		$10.08	$24.89	$40.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.08 / $25.93 / $41.77	Professional		$10.08	$25.93	$41.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.98 / $218.77 / $324.91	Facility		$40.98	$218.77	$324.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $13.25	Facility	26	$11.16	$11.16	$13.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.78 / $26.10 / $26.10	Facility	TC	$24.78	$26.10	$26.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.69 / $42.25 / $72.11	Professional		$27.69	$42.25	$72.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.84 / $13.24 / $22.56	Professional	26	$8.84	$13.24	$22.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $29.27 / $49.00	Professional	TC	$18.87	$29.27	$49.00
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $80.39 / $227.74 / $433.07	Facility		$80.39	$227.74	$433.07
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $13.25	Facility	26	$11.16	$11.16	$13.25
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $24.78 / $217.78 / $363.87	Facility	TC	$24.78	$217.78	$363.87
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.44 / $72.61	Professional		$27.54	$41.44	$72.61
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $9.30 / $14.60 / $27.36	Professional	26	$9.30	$14.60	$27.36
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $28.93 / $47.53	Professional	TC	$18.87	$28.93	$47.53
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 $26.19 / $36.09 / $63.34	Professional		$26.19	$36.09	$63.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.84 / $11.98 / $20.94	Professional	26	$8.84	$11.98	$20.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.55 / $23.83 / $41.90	Professional	TC	$17.55	$23.83	$41.90