Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.72 / $233.18 / $494.44	Facility		$53.72	$233.18	$494.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.49 / $10.71 / $26.60	Facility	26	$7.49	$10.71	$26.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.27 / $281.06 / $665.52	Facility	TC	$31.27	$281.06	$665.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.61 / $29.36 / $80.00	Professional		$10.61	$29.36	$80.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.32 / $11.10 / $44.00	Professional	26	$7.32	$11.10	$44.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.43 / $32.76 / $112.62	Professional	50	$28.43	$32.76	$112.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $23.86 / $46.36	Professional	TC	$17.57	$23.86	$46.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.65 / $24.74 / $28.62	Professional		$21.65	$24.74	$28.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $7.79 / $12.74	Professional	26	$5.82	$7.79	$12.74
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $35.44 / $35.44 / $35.44	Professional	50	$35.44	$35.44	$35.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.60 / $21.68 / $32.95	Professional	TC	$17.60	$21.68	$32.95
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 $25.70 / $31.73 / $54.83	Professional		$25.70	$31.73	$54.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.17 / $10.41 / $18.98	Professional	26	$8.17	$10.41	$18.98
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.54 / $48.03 / $82.26	Professional	50	$38.54	$48.03	$82.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $21.81 / $35.67	Professional	TC	$16.89	$21.81	$35.67
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $33.67 / $33.67 / $37.09	Professional		$33.67	$33.67	$37.09
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $8.59 / $9.46	Professional	26	$8.59	$8.59	$9.46
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $25.09 / $25.09 / $27.64	Professional	TC	$25.09	$25.09	$27.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.00 / $25.51 / $38.52	Facility		$8.00	$25.51	$38.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.01 / $26.66 / $39.94	Professional		$8.01	$26.66	$39.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $162.54 / $268.55	Facility		$35.40	$162.54	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $9.48	Facility	26	$8.86	$8.86	$9.48
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.22 / $26.85 / $26.85	Facility	TC	$23.22	$26.85	$26.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.25 / $37.13 / $67.92	Professional		$25.25	$37.13	$67.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.91 / $10.37 / $17.64	Professional	26	$6.91	$10.37	$17.64
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.29 / $38.29 / $38.29	Professional	50	$38.29	$38.29	$38.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.14 / $26.57 / $49.79	Professional	TC	$18.14	$26.57	$49.79
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $90.35 / $211.10 / $361.26	Facility		$90.35	$211.10	$361.26
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $9.48	Facility	26	$8.86	$8.86	$9.48
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $23.22 / $219.80 / $363.16	Facility	TC	$23.22	$219.80	$363.16
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.64 / $36.81 / $67.92	Professional		$24.64	$36.81	$67.92
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $12.17 / $23.99	Professional	26	$7.64	$12.17	$23.99
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $19.18 / $26.57 / $46.36	Professional	TC	$19.18	$26.57	$46.36
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 $22.38 / $32.74 / $58.50	Professional		$22.38	$32.74	$58.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.67 / $9.21 / $15.90	Professional	26	$6.67	$9.21	$15.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.47 / $23.63 / $43.08	Professional	TC	$16.47	$23.63	$43.08