Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.43 / $205.96 / $422.02	Facility		$55.43	$205.96	$422.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.79 / $11.14 / $27.68	Facility	26	$7.79	$11.14	$27.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.82 / $259.44 / $619.40	Facility	TC	$31.82	$259.44	$619.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.21 / $32.42 / $62.03	Professional		$16.21	$32.42	$62.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $10.81 / $30.79	Professional	26	$7.43	$10.81	$30.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $120.00 / $120.00 / $120.00	Professional	50	$120.00	$120.00	$120.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.28 / $15.75 / $27.84	Professional	52	$11.28	$15.75	$27.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $25.68 / $50.22	Professional	TC	$20.07	$25.68	$50.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.39 / $24.24 / $39.92	Professional		$19.39	$24.24	$39.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.48 / $7.62 / $10.60	Professional	26	$4.48	$7.62	$10.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $18.82 / $18.82	Professional	TC	$18.82	$18.82	$18.82
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 / $31.32 / $52.38	Professional		$24.60	$31.32	$52.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $9.82 / $17.47	Professional	26	$8.02	$9.82	$17.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.90 / $47.36 / $78.56	Professional	50	$36.90	$47.36	$78.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.57 / $21.62 / $36.57	Professional	TC	$16.57	$21.62	$36.57
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $35.75 / $35.75 / $39.39	Professional		$35.75	$35.75	$39.39
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $8.93 / $9.84	Professional	26	$8.93	$8.93	$9.84
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $26.82 / $26.82 / $29.55	Professional	TC	$26.82	$26.82	$29.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.33 / $27.28 / $40.90	Facility		$8.33	$27.28	$40.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.33 / $28.53 / $42.43	Professional		$8.33	$28.53	$42.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.98 / $166.60 / $268.55	Facility		$40.98	$166.60	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.86	Facility	26	$9.19	$9.19	$9.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.56 / $29.08 / $29.08	Facility	TC	$25.56	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.08 / $39.39 / $72.87	Professional		$27.08	$39.39	$72.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $10.75 / $18.21	Professional	26	$7.20	$10.75	$18.21
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $41.47	Professional	50	$41.47	$41.47	$41.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $28.41 / $51.79	Professional	TC	$19.93	$28.41	$51.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $64.03 / $178.95 / $342.30	Facility		$64.03	$178.95	$342.30
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.86	Facility	26	$9.19	$9.19	$9.86
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $25.56 / $176.67 / $354.27	Facility	TC	$25.56	$176.67	$354.27
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $27.12 / $39.54 / $68.68	Professional		$27.12	$39.54	$68.68
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $11.74 / $21.68	Professional	26	$7.67	$11.74	$21.68
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $20.64 / $28.77 / $50.91	Professional	TC	$20.64	$28.77	$50.91
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 $24.23 / $33.20 / $61.76	Professional		$24.23	$33.20	$61.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.67 / $9.53 / $16.45	Professional	26	$6.67	$9.53	$16.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.91 / $24.99 / $44.89	Professional	TC	$16.91	$24.99	$44.89