Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.78 / $235.42 / $522.14	Facility		$63.78	$235.42	$522.14
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 $44.81 / $314.89 / $693.72	Facility	TC	$44.81	$314.89	$693.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.37 / $34.54 / $78.68	Professional		$11.37	$34.54	$78.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.78 / $12.99 / $42.45	Professional	26	$7.78	$12.99	$42.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.43 / $41.60 / $114.57	Professional	50	$28.43	$41.60	$114.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $31.04 / $57.79	Professional	TC	$21.64	$31.04	$57.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.26 / $29.26 / $60.00	Professional		$24.26	$29.26	$60.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $9.64 / $14.53	Professional	26	$6.32	$9.64	$14.53
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $32.10 / $41.44 / $44.00	Professional	50	$32.10	$41.44	$44.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.27 / $34.04 / $39.79	Professional	TC	$21.27	$34.04	$39.79
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 $26.66 / $33.14 / $55.87	Professional		$26.66	$33.14	$55.87
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 $39.99 / $50.35 / $83.80	Professional	50	$39.99	$50.35	$83.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.86 / $23.37 / $40.06	Professional	TC	$17.86	$23.37	$40.06
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $39.61 / $43.98	Professional		$39.61	$39.61	$43.98
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.32 / $9.32 / $10.35	Professional	26	$9.32	$9.32	$10.35
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $30.30 / $30.30 / $33.64	Professional	TC	$30.30	$30.30	$33.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $30.82 / $45.32	Facility		$8.69	$30.82	$45.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.69 / $32.26 / $47.00	Professional		$8.69	$32.26	$47.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.17 / $166.60 / $268.55	Facility		$44.17	$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 $26.72 / $32.44 / $32.44	Facility	TC	$26.72	$32.44	$32.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.70 / $42.27 / $78.61	Professional		$28.70	$42.27	$78.61
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 $43.28 / $43.28 / $43.28	Professional	50	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.75 / $30.81 / $57.51	Professional	TC	$21.75	$30.81	$57.51
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $104.51 / $226.11 / $427.36	Facility		$104.51	$226.11	$427.36
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $10.31 / $156.68	Facility	26	$9.61	$10.31	$156.68
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $26.72 / $286.89 / $356.22	Facility	TC	$26.72	$286.89	$356.22
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $26.15 / $42.27 / $77.22	Professional		$26.15	$42.27	$77.22
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $12.63 / $23.89	Professional	26	$8.01	$12.63	$23.89
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $74.84 / $74.84 / $74.84	Professional	50	$74.84	$74.84	$74.84
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $22.22 / $32.10 / $54.83	Professional	TC	$22.22	$32.10	$54.83
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 Facility Modifier Low / Median / High Price $9.86 / $28.03 / $68.97	Facility		$9.86	$28.03	$68.97
United Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $37.99 / $67.20	Professional		$25.98	$37.99	$67.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $9.99 / $17.27	Professional	26	$6.95	$9.99	$17.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.23 / $26.79 / $48.16	Professional	TC	$19.23	$26.79	$48.16