Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.83 / $227.61 / $545.64	Facility		$59.83	$227.61	$545.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $14.78 / $211.01	Facility	26	$8.13	$14.78	$211.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $44.66 / $296.10 / $629.79	Facility	TC	$44.66	$296.10	$629.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.37 / $39.60 / $91.79	Professional		$11.37	$39.60	$91.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $12.85 / $35.46	Professional	26	$7.90	$12.85	$35.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.43 / $28.48 / $114.68	Professional	50	$28.43	$28.48	$114.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.37 / $35.50 / $66.43	Professional	TC	$25.37	$35.50	$66.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.81 / $31.54 / $60.00	Professional		$26.81	$31.54	$60.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.19 / $8.21 / $13.83	Professional	26	$6.19	$8.21	$13.83
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $42.57 / $45.84 / $46.05	Professional	50	$42.57	$45.84	$46.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $24.21 / $28.98 / $45.28	Professional	TC	$24.21	$28.98	$45.28
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 $27.61 / $35.89 / $58.83	Professional		$27.61	$35.89	$58.83
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 $41.41 / $52.74 / $88.24	Professional	50	$41.41	$52.74	$88.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.80 / $25.01 / $43.81	Professional	TC	$18.80	$25.01	$43.81
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $43.79 / $48.24 / $48.61	Professional		$43.79	$48.24	$48.61
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.32 / $10.27 / $10.35	Professional	26	$9.32	$10.27	$10.35
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $34.47 / $37.97 / $38.27	Professional	TC	$34.47	$37.97	$38.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $35.04 / $50.15	Facility		$8.69	$35.04	$50.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.69 / $35.88 / $52.75	Professional		$8.69	$35.88	$52.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.10 / $166.60 / $268.55	Facility		$53.10	$166.60	$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 $30.23 / $36.90 / $36.90	Facility	TC	$30.23	$36.90	$36.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.71 / $46.47 / $87.09	Professional		$31.71	$46.47	$87.09
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 $47.36 / $47.36 / $47.36	Professional	50	$47.36	$47.36	$47.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.04 / $35.64 / $66.91	Professional	TC	$24.04	$35.64	$66.91
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $103.44 / $229.05 / $391.27	Facility		$103.44	$229.05	$391.27
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 $30.23 / $193.47 / $362.18	Facility	TC	$30.23	$193.47	$362.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $30.39 / $46.47 / $87.09	Professional		$30.39	$46.47	$87.09
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $12.45 / $23.89	Professional	26	$8.01	$12.45	$23.89
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $25.32 / $37.11 / $68.81	Professional	TC	$25.32	$37.11	$68.81
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 $27.69 / $40.64 / $74.75	Professional		$27.69	$40.64	$74.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $9.92 / $17.61	Professional	26	$6.95	$9.92	$17.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.66 / $30.97 / $56.05	Professional	TC	$20.66	$30.97	$56.05