Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.27 / $247.53 / $624.87	Facility		$52.27	$247.53	$624.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.76 / $15.94 / $78.83	Facility	26	$8.76	$15.94	$78.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.40 / $314.89 / $667.40	Facility	TC	$40.40	$314.89	$667.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.23 / $33.99 / $87.65	Professional		$12.23	$33.99	$87.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $12.82 / $38.15	Professional	26	$8.56	$12.82	$38.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $27.27 / $76.08 / $136.44	Professional	50	$27.27	$76.08	$136.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.23 / $29.81 / $60.32	Professional	TC	$20.23	$29.81	$60.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.57 / $27.27 / $48.42	Professional		$22.57	$27.27	$48.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $10.03 / $14.89	Professional	26	$6.71	$10.03	$14.89
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $33.86 / $38.52 / $40.90	Professional	50	$33.86	$38.52	$40.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.71 / $23.18 / $35.22	Professional	TC	$19.71	$23.18	$35.22
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 $25.10 / $33.72 / $56.23	Professional		$25.10	$33.72	$56.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.10 / $10.92 / $19.11	Professional	26	$9.10	$10.92	$19.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.65 / $50.89 / $85.54	Professional	50	$37.65	$50.89	$85.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.00 / $22.61 / $38.99	Professional	TC	$16.00	$22.61	$38.99
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $40.61 / $57.17	Professional		$36.86	$40.61	$57.17
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $11.06 / $15.57	Professional	26	$10.03	$11.06	$15.57
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $26.82 / $29.55 / $41.60	Professional	TC	$26.82	$29.55	$41.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.36 / $27.28 / $42.17	Facility		$9.36	$27.28	$42.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.36 / $28.53 / $43.74	Professional		$9.36	$28.53	$43.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.14 / $162.54 / $268.55	Facility		$39.14	$162.54	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $11.13	Facility	26	$10.36	$10.36	$11.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $22.44 / $29.08 / $29.08	Facility	TC	$22.44	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.90 / $40.97 / $73.02	Professional		$27.90	$40.97	$73.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.09 / $12.06 / $20.52	Professional	26	$8.09	$12.06	$20.52
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.20 / $39.20 / $39.20	Professional	50	$39.20	$39.20	$39.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.77 / $28.12 / $50.91	Professional	TC	$19.77	$28.12	$50.91
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $105.70 / $238.49 / $404.58	Facility		$105.70	$238.49	$404.58
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $11.13	Facility	26	$10.36	$10.36	$11.13
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $287.04 / $353.16	Facility	TC	$29.08	$287.04	$353.16
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $27.21 / $40.61 / $74.42	Professional		$27.21	$40.61	$74.42
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $14.18 / $26.85	Professional	26	$8.64	$14.18	$26.85
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $30.00 / $30.00 / $70.76	Professional	50	$30.00	$30.00	$70.76
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $20.46 / $28.41 / $47.73	Professional	TC	$20.46	$28.41	$47.73
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 $25.60 / $33.86 / $62.55	Professional		$25.60	$33.86	$62.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $10.72 / $18.51	Professional	26	$7.45	$10.72	$18.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.44 / $24.75 / $42.72	Professional	TC	$17.44	$24.75	$42.72