Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.70 / $160.88 / $363.78	Facility		$48.70	$160.88	$363.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $11.38 / $28.86	Facility	26	$8.13	$11.38	$28.86
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.23 / $251.92 / $364.72	Facility	TC	$28.23	$251.92	$364.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.46 / $33.03 / $64.23	Professional		$26.46	$33.03	$64.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.67 / $26.32	Professional	26	$7.33	$10.67	$26.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $23.87 / $45.59	Professional	TC	$19.14	$23.87	$45.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.20 / $25.70 / $30.97	Professional		$24.20	$25.70	$30.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $9.28 / $13.83	Professional	26	$6.19	$9.28	$13.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $21.98 / $33.40	Professional	TC	$21.38	$21.98	$33.40
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 $27.63 / $33.50 / $56.17	Professional		$27.63	$33.50	$56.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.80 / $10.33 / $18.11	Professional	26	$8.80	$10.33	$18.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.16 / $39.34	Professional	TC	$18.82	$23.16	$39.34
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $34.75 / $34.75 / $34.75	Professional		$34.75	$34.75	$34.75
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.32 / $9.32 / $9.32	Professional	26	$9.32	$9.32	$9.32
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $25.43 / $25.43 / $25.43	Professional	TC	$25.43	$25.43	$25.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $25.86 / $39.76	Facility		$8.69	$25.86	$39.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.69 / $27.04 / $41.23	Professional		$8.69	$27.04	$41.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $162.54 / $268.55	Facility		$37.15	$162.54	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $10.31	Facility	26	$9.61	$9.61	$10.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.61 / $27.22 / $27.22	Facility	TC	$23.61	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $38.90 / $69.59	Professional		$26.30	$38.90	$69.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $11.18 / $18.89	Professional	26	$7.36	$11.18	$18.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $27.80 / $49.03	Professional	TC	$19.14	$27.80	$49.03
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $58.05 / $177.39 / $381.30	Facility		$58.05	$177.39	$381.30
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $10.31	Facility	26	$9.61	$9.61	$10.31
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $23.61 / $27.22 / $362.18	Facility	TC	$23.61	$27.22	$362.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $26.03 / $38.79 / $62.60	Professional		$26.03	$38.79	$62.60
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $11.73 / $22.81	Professional	26	$7.98	$11.73	$22.81
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $19.72 / $27.89 / $48.27	Professional	TC	$19.72	$27.89	$48.27
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 $25.76 / $34.57 / $59.69	Professional		$25.76	$34.57	$59.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.98 / $17.27	Professional	26	$7.41	$9.98	$17.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.51 / $24.39 / $43.20	Professional	TC	$17.51	$24.39	$43.20