Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.53 / $247.16 / $474.00	Facility		$53.53	$247.16	$474.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $13.45 / $70.64	Facility	26	$8.13	$13.45	$70.64
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.15 / $297.98 / $622.28	Facility	TC	$32.15	$297.98	$622.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.79 / $30.83 / $65.50	Professional		$10.79	$30.83	$65.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.33 / $30.20	Professional	26	$7.76	$11.33	$30.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $27.32 / $61.80 / $79.14	Professional	50	$27.32	$61.80	$79.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.81 / $28.25 / $52.54	Professional	TC	$20.81	$28.25	$52.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $25.03 / $45.65	Professional		$21.28	$25.03	$45.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $8.39 / $13.83	Professional	26	$6.32	$8.39	$13.83
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $31.91 / $36.29 / $36.56	Professional	50	$31.91	$36.29	$36.56
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 $29.22 / $35.68 / $59.34	Professional		$29.22	$35.68	$59.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.80 / $10.38 / $18.11	Professional	26	$8.80	$10.38	$18.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $43.83 / $53.01 / $89.01	Professional	50	$43.83	$53.01	$89.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $25.03 / $42.28	Professional	TC	$20.42	$25.03	$42.28
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $34.75 / $34.75 / $38.29	Professional		$34.75	$34.75	$38.29
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.32 / $9.32 / $10.27	Professional	26	$9.32	$9.32	$10.27
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $25.43 / $25.43 / $28.02	Professional	TC	$25.43	$25.43	$28.02
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 $45.44 / $162.54 / $268.55	Facility		$45.44	$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 $22.83 / $27.59 / $27.59	Facility	TC	$22.83	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $41.32 / $72.45	Professional		$27.00	$41.32	$72.45
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 50 Low / Median / High Price $38.75 / $38.75 / $38.75	Professional	50	$38.75	$38.75	$38.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $29.74 / $51.17	Professional	TC	$19.50	$29.74	$51.17
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $103.65 / $251.71 / $436.50	Facility		$103.65	$251.71	$436.50
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 $22.83 / $231.05 / $354.56	Facility	TC	$22.83	$231.05	$354.56
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $26.56 / $41.21 / $72.56	Professional		$26.56	$41.21	$72.56
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.99 / $12.33 / $24.51	Professional	26	$7.99	$12.33	$24.51
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $30.17 / $51.12	Professional	TC	$19.76	$30.17	$51.12
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 $26.02 / $34.90 / $60.14	Professional		$26.02	$34.90	$60.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.35 / $9.98 / $17.27	Professional	26	$7.35	$9.98	$17.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $24.62 / $43.26	Professional	TC	$19.07	$24.62	$43.26