Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.91 / $259.61 / $551.79	Facility		$49.91	$259.61	$551.79
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 $28.93 / $306.44 / $667.40	Facility	TC	$28.93	$306.44	$667.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.46 / $29.36 / $57.83	Professional		$14.46	$29.36	$57.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $11.82 / $37.00	Professional	26	$7.22	$11.82	$37.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $14.51 / $56.12 / $56.12	Professional	50	$14.51	$56.12	$56.12
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.53 / $14.68 / $25.64	Professional	52	$10.53	$14.68	$25.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $23.04 / $48.42	Professional	TC	$17.89	$23.04	$48.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.07 / $24.00 / $32.47	Professional		$18.07	$24.00	$32.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $9.84 / $15.90	Professional	26	$5.94	$9.84	$15.90
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.39 / $37.03 / $37.03	Professional	50	$32.39	$37.03	$37.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $32.04 / $32.04 / $32.04	Professional	TC	$32.04	$32.04	$32.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $246.06 / $260.52 / $297.37	Facility		$246.06	$260.52	$297.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.66 / $30.49 / $51.74	Professional		$24.66	$30.49	$51.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.31 / $9.82 / $17.55	Professional	26	$8.31	$9.82	$17.55
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.99 / $46.40 / $77.61	Professional	50	$36.99	$46.40	$77.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $20.81 / $34.32	Professional	TC	$16.26	$20.81	$34.32
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $33.32 / $33.32 / $36.71	Professional		$33.32	$33.32	$36.71
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 $24.39 / $24.39 / $26.87	Professional	TC	$24.39	$24.39	$26.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.33 / $24.80 / $38.11	Facility		$8.33	$24.80	$38.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.33 / $25.93 / $39.54	Professional		$8.33	$25.93	$39.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $218.77 / $324.91	Facility		$35.40	$218.77	$324.91
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 $22.44 / $26.47 / $26.47	Facility	TC	$22.44	$26.47	$26.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.24 / $36.68 / $66.73	Professional		$25.24	$36.68	$66.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.06 / $10.60 / $17.82	Professional	26	$7.06	$10.60	$17.82
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.85 / $37.85 / $37.85	Professional	50	$37.85	$37.85	$37.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.09 / $25.56 / $46.29	Professional	TC	$18.09	$25.56	$46.29
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $55.04 / $214.99 / $325.02	Facility		$55.04	$214.99	$325.02
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 $22.44 / $185.09 / $348.76	Facility	TC	$22.44	$185.09	$348.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.61 / $36.50 / $59.85	Professional		$24.61	$36.50	$59.85
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $11.26 / $21.58	Professional	26	$7.65	$11.26	$21.58
Medical Mutual of Ohio Facility/Professional Professional Modifier 52 Low / Median / High Price $28.00 / $28.00 / $28.00	Professional	52	$28.00	$28.00	$28.00
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.83 / $44.14	Professional	TC	$18.62	$25.83	$44.14
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 $23.85 / $32.18 / $57.15	Professional		$23.85	$32.18	$57.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.99 / $9.59 / $16.55	Professional	26	$6.99	$9.59	$16.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.86 / $22.41 / $40.28	Professional	TC	$15.86	$22.41	$40.28