Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.90 / $225.60 / $394.75	Facility		$51.90	$225.60	$394.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.49 / $10.71 / $27.68	Facility	26	$7.49	$10.71	$27.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.73 / $253.57 / $364.72	Facility	TC	$27.73	$253.57	$364.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.13 / $29.67 / $60.57	Professional		$11.13	$29.67	$60.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.34 / $10.45 / $28.19	Professional	26	$7.34	$10.45	$28.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.48 / $46.46	Professional	TC	$18.82	$23.48	$46.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $25.15 / $30.33	Professional		$23.87	$25.15	$30.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.70 / $8.55 / $12.74	Professional	26	$5.70	$8.55	$12.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.85 / $33.40 / $33.40	Professional	TC	$17.85	$33.40	$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 / $33.26 / $56.17	Professional		$27.63	$33.26	$56.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.80 / $10.25 / $18.11	Professional	26	$8.80	$10.25	$18.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.27 / $39.34	Professional	TC	$18.82	$23.27	$39.34
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $34.02 / $37.47 / $37.47	Professional		$34.02	$37.47	$37.47
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $9.46 / $9.46	Professional	26	$8.59	$9.46	$9.46
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $25.43 / $28.02 / $28.02	Professional	TC	$25.43	$28.02	$28.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.00 / $25.86 / $38.92	Facility		$8.00	$25.86	$38.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.01 / $27.04 / $40.36	Professional		$8.01	$27.04	$40.36
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 $8.86 / $8.86 / $9.86	Facility	26	$8.86	$8.86	$9.86
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 $25.78 / $38.79 / $68.63	Professional		$25.78	$38.79	$68.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.97 / $10.55 / $17.64	Professional	26	$6.97	$10.55	$17.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $27.79 / $50.48	Professional	TC	$19.14	$27.79	$50.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $68.58 / $185.75 / $346.98	Facility		$68.58	$185.75	$346.98
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $9.86	Facility	26	$8.86	$8.86	$9.86
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $23.61 / $243.50 / $364.17	Facility	TC	$23.61	$243.50	$364.17
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $25.32 / $38.60 / $62.69	Professional		$25.32	$38.60	$62.69
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $11.64 / $21.13	Professional	26	$7.64	$11.64	$21.13
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $28.02 / $48.27	Professional	TC	$19.54	$28.02	$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 $25.32 / $33.79 / $59.13	Professional		$25.32	$33.79	$59.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.75 / $9.53 / $16.55	Professional	26	$6.75	$9.53	$16.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.23 / $23.51 / $43.24	Professional	TC	$17.23	$23.51	$43.24