Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.22 / $194.30 / $403.85	Facility		$45.22	$194.30	$403.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.79 / $10.90 / $26.50	Facility	26	$7.79	$10.90	$26.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.45 / $52.71 / $403.85	Facility	TC	$19.45	$52.71	$403.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.74 / $29.12 / $58.12	Professional		$15.74	$29.12	$58.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $10.72 / $25.61	Professional	26	$7.01	$10.72	$25.61
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $116.00 / $117.92 / $117.92	Professional	50	$116.00	$117.92	$117.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.18 / $21.83 / $40.77	Professional	TC	$17.18	$21.83	$40.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.21 / $23.13 / $35.86	Professional		$17.21	$23.13	$35.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $9.69 / $12.92	Professional	26	$5.94	$9.69	$12.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.65 / $29.30 / $29.30	Professional	TC	$15.65	$29.30	$29.30
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 $24.60 / $29.94 / $49.78	Professional		$24.60	$29.94	$49.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.70 / $9.31 / $15.77	Professional	26	$7.70	$9.31	$15.77
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.90 / $44.91 / $75.22	Professional	50	$36.90	$44.91	$75.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $20.79 / $35.31	Professional	TC	$16.89	$20.79	$35.31
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $34.40 / $34.40	Professional		$34.40	$34.40	$34.40
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.84 / $9.84 / $9.84	Professional	26	$9.84	$9.84	$9.84
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $24.57 / $24.57 / $24.57	Professional	TC	$24.57	$24.57	$24.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.33 / $22.68 / $35.72	Facility		$8.33	$22.68	$35.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.33 / $23.69 / $37.06	Professional		$8.33	$23.69	$37.06
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 $9.19 / $9.19 / $9.44	Facility	26	$9.19	$9.19	$9.44
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $20.49 / $23.86 / $23.86	Facility	TC	$20.49	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.44 / $36.13 / $62.96	Professional		$24.44	$36.13	$62.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.84 / $10.53 / $17.42	Professional	26	$6.84	$10.53	$17.42
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.11 / $35.11 / $35.11	Professional	50	$35.11	$35.11	$35.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.07 / $25.33 / $44.66	Professional	TC	$17.07	$25.33	$44.66
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $68.93 / $184.42 / $317.69	Facility		$68.93	$184.42	$317.69
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.44	Facility	26	$9.19	$9.19	$9.44
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $20.49 / $23.86 / $301.16	Facility	TC	$20.49	$23.86	$301.16
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.44 / $35.50 / $60.88	Professional		$24.44	$35.50	$60.88
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $11.00 / $22.04	Professional	26	$7.66	$11.00	$22.04
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $17.61 / $25.88 / $43.47	Professional	TC	$17.61	$25.88	$43.47
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 Facility Modifier Low / Median / High Price $8.61 / $26.60 / $54.19	Facility		$8.61	$26.60	$54.19
United Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $31.18 / $54.85	Professional		$23.10	$31.18	$54.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.78 / $9.44 / $16.45	Professional	26	$6.78	$9.44	$16.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.56 / $21.37 / $38.31	Professional	TC	$15.56	$21.37	$38.31