Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.21 / $216.24 / $417.14	Facility		$53.21	$216.24	$417.14
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $11.84 / $30.04	Facility	26	$8.46	$11.84	$30.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.22 / $276.36 / $682.44	Facility	TC	$32.22	$276.36	$682.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.88 / $33.06 / $62.71	Professional		$8.88	$33.06	$62.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $11.23 / $24.69	Professional	26	$8.22	$11.23	$24.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.02 / $18.02 / $400.40	Professional	50	$18.02	$18.02	$400.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $25.80 / $48.46	Professional	TC	$20.96	$25.80	$48.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $28.02 / $33.81	Professional		$25.70	$28.02	$33.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.58 / $10.05 / $17.26	Professional	26	$6.58	$10.05	$17.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $37.06 / $37.06	Professional	TC	$16.26	$37.06	$37.06
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 $29.05 / $36.90 / $62.19	Professional		$29.05	$36.90	$62.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $10.66 / $18.82	Professional	26	$8.77	$10.66	$18.82
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $43.52 / $55.02 / $93.29	Professional	50	$43.52	$55.02	$93.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.08 / $26.26 / $42.97	Professional	TC	$21.08	$26.26	$42.97
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $37.90 / $41.77	Professional		$37.90	$37.90	$41.77
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $9.69 / $10.69	Professional	26	$9.69	$9.69	$10.69
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $28.21 / $28.21 / $31.08	Professional	TC	$28.21	$28.21	$31.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.03 / $28.69 / $43.38	Facility		$9.03	$28.69	$43.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.03 / $30.03 / $44.98	Professional		$9.03	$30.03	$44.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.89 / $173.99 / $268.55	Facility		$39.89	$173.99	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.74	Facility	26	$10.01	$10.01	$10.74
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.33 / $30.20 / $30.20	Facility	TC	$26.33	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.97 / $42.49 / $74.03	Professional		$28.97	$42.49	$74.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $11.78 / $19.87	Professional	26	$7.65	$11.78	$19.87
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 $21.24 / $30.52 / $56.01	Professional	TC	$21.24	$30.52	$56.01
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $96.26 / $196.70 / $363.29	Facility		$96.26	$196.70	$363.29
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.74	Facility	26	$10.01	$10.01	$10.74
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $26.33 / $227.85 / $333.64	Facility	TC	$26.33	$227.85	$333.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $29.58 / $42.47 / $69.64	Professional		$29.58	$42.47	$69.64
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $12.64 / $24.44	Professional	26	$8.34	$12.64	$24.44
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $22.32 / $30.84 / $50.26	Professional	TC	$22.32	$30.84	$50.26
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 $28.24 / $38.56 / $65.90	Professional		$28.24	$38.56	$65.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.69 / $10.68 / $18.76	Professional	26	$7.69	$10.68	$18.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.36 / $26.97 / $48.46	Professional	TC	$19.36	$26.97	$48.46