Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.84 / $232.07 / $434.28	Facility		$49.84	$232.07	$434.28
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 $27.64 / $277.39 / $434.28	Facility	TC	$27.64	$277.39	$434.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.52 / $27.78 / $57.75	Professional		$10.52	$27.78	$57.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.14 / $10.58 / $26.24	Professional	26	$7.14	$10.58	$26.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.32 / $102.00 / $102.00	Professional	50	$15.32	$102.00	$102.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $22.70 / $41.87	Professional	TC	$17.78	$22.70	$41.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.21 / $21.93 / $34.86	Professional		$17.21	$21.93	$34.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.74 / $7.34 / $12.06	Professional	26	$5.74	$7.34	$12.06
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $19.57 / $25.58	Professional	TC	$19.57	$19.57	$25.58
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 $25.35 / $30.45 / $50.64	Professional		$25.35	$30.45	$50.64
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.31 / $9.49 / $16.78	Professional	26	$8.31	$9.49	$16.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $45.68 / $75.95	Professional	50	$38.02	$45.68	$75.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $20.72 / $35.31	Professional	TC	$16.89	$20.72	$35.31
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $31.23 / $34.40 / $34.40	Professional		$31.23	$34.40	$34.40
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 $22.64 / $24.95 / $24.95	Professional	TC	$22.64	$24.95	$24.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.00 / $23.03 / $35.72	Facility		$8.00	$23.03	$35.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.01 / $24.05 / $37.06	Professional		$8.01	$24.05	$37.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.86 / $162.54 / $268.55	Facility		$35.86	$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 $21.27 / $24.24 / $24.24	Facility	TC	$21.27	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.91 / $35.50 / $62.96	Professional		$23.91	$35.50	$62.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $10.27 / $17.51	Professional	26	$6.77	$10.27	$17.51
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.49 / $36.49 / $36.49	Professional	50	$36.49	$36.49	$36.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.34 / $25.18 / $43.51	Professional	TC	$17.34	$25.18	$43.51
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $104.25 / $219.06 / $360.73	Facility		$104.25	$219.06	$360.73
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 $21.27 / $24.24 / $360.22	Facility	TC	$21.27	$24.24	$360.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.28 / $35.53 / $62.96	Professional		$24.28	$35.53	$62.96
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.49 / $11.56 / $22.65	Professional	26	$7.49	$11.56	$22.65
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $17.93 / $25.60 / $42.99	Professional	TC	$17.93	$25.60	$42.99
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 $22.82 / $32.15 / $57.41	Professional		$22.82	$32.15	$57.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.99 / $9.35 / $16.55	Professional	26	$6.99	$9.35	$16.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.71 / $21.60 / $38.90	Professional	TC	$14.71	$21.60	$38.90