Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.03 / $201.20 / $509.25	Facility		$49.03	$201.20	$509.25
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.40 / $18.93 / $264.14	Facility	26	$10.40	$18.93	$264.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.01 / $287.64 / $546.94	Facility	TC	$35.01	$287.64	$546.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $46.83 / $109.89	Professional		$35.54	$46.83	$109.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $14.63 / $36.56	Professional	26	$10.02	$14.63	$36.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.15 / $31.04 / $56.88	Professional	TC	$25.15	$31.04	$56.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.41 / $31.22 / $55.46	Professional		$29.41	$31.22	$55.46
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.03 / $11.95 / $17.68	Professional	26	$8.03	$11.95	$17.68
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.27 / $26.19 / $39.79	Professional	TC	$21.27	$26.19	$39.79
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 $32.83 / $41.07 / $69.08	Professional		$32.83	$41.07	$69.08
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.28 / $13.54 / $24.60	Professional	26	$11.28	$13.54	$24.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.45 / $27.79 / $45.09	Professional	TC	$21.45	$27.79	$45.09
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $42.22 / $42.22 / $46.87	Professional		$42.22	$42.22	$46.87
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $11.92 / $11.92 / $13.23	Professional	26	$11.92	$11.92	$13.23
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $30.30 / $30.30 / $33.64	Professional	TC	$30.30	$30.30	$33.64
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 $44.74 / $218.77 / $324.91	Facility		$44.74	$218.77	$324.91
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 / $32.79 / $32.79	Facility	TC	$27.50	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.68 / $48.27 / $85.64	Professional		$32.68	$48.27	$85.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $14.32 / $24.30	Professional	26	$9.59	$14.32	$24.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $34.29 / $59.29	Professional	TC	$23.08	$34.29	$59.29
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $102.94 / $236.40 / $467.53	Facility		$102.94	$236.40	$467.53
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 / $285.12 / $677.31	Facility	TC	$27.50	$285.12	$677.31
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $31.82 / $48.27 / $88.40	Professional		$31.82	$48.27	$88.40
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.27 / $16.82 / $30.20	Professional	26	$10.27	$16.82	$30.20
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $35.15 / $57.10	Professional	TC	$23.57	$35.15	$57.10
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 $31.55 / $42.09 / $73.38	Professional		$31.55	$42.09	$73.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.18 / $12.72 / $22.44	Professional	26	$9.18	$12.72	$22.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.49 / $29.16 / $51.43	Professional	TC	$21.49	$29.16	$51.43