Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.59 / $194.30 / $364.72	Facility		$49.59	$194.30	$364.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.49 / $10.71 / $27.68	Facility	26	$7.49	$10.71	$27.68
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.16 / $215.94 / $411.72	Facility	TC	$30.16	$215.94	$411.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.10 / $29.97 / $59.42	Professional		$13.10	$29.97	$59.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $10.52 / $26.14	Professional	26	$7.03	$10.52	$26.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.90 / $23.72 / $495.73	Professional	50	$15.90	$23.72	$495.73
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.18 / $15.28 / $26.74	Professional	52	$12.18	$15.28	$26.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $24.27 / $44.28	Professional	TC	$18.53	$24.27	$44.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.70 / $24.50 / $30.33	Professional		$23.70	$24.50	$30.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $9.32 / $12.74	Professional	26	$5.82	$9.32	$12.74
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 $24.66 / $30.93 / $51.74	Professional		$24.66	$30.93	$51.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.59 / $17.55	Professional	26	$8.13	$9.59	$17.55
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.99 / $47.01 / $77.61	Professional	50	$36.99	$47.01	$77.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $21.13 / $35.10	Professional	TC	$16.26	$21.13	$35.10
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $34.02 / $34.02 / $37.47	Professional		$34.02	$34.02	$37.47
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 $25.43 / $25.43 / $28.02	Professional	TC	$25.43	$25.43	$28.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.00 / $25.86 / $38.92	Facility		$8.00	$25.86	$38.92
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.01 / $27.04 / $40.36	Professional		$8.01	$27.04	$40.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.15 / $162.54 / $268.55	Facility		$37.15	$162.54	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $9.86	Facility	26	$8.86	$8.86	$9.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.39 / $27.59 / $27.59	Facility	TC	$24.39	$27.59	$27.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.71 / $37.47 / $69.33	Professional		$25.71	$37.47	$69.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $10.34 / $17.64	Professional	26	$6.77	$10.34	$17.64
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.11 / $40.11 / $40.11	Professional	50	$40.11	$40.11	$40.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.66 / $26.95 / $51.17	Professional	TC	$18.66	$26.95	$51.17
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $58.05 / $173.99 / $312.93	Facility		$58.05	$173.99	$312.93
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $9.86	Facility	26	$8.86	$8.86	$9.86
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $24.39 / $44.14 / $360.86	Facility	TC	$24.39	$44.14	$360.86
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $25.51 / $36.97 / $62.54	Professional		$25.51	$36.97	$62.54
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.49 / $10.99 / $20.76	Professional	26	$7.49	$10.99	$20.76
Medical Mutual of Ohio Facility/Professional Professional Modifier 52 Low / Median / High Price $9.92 / $9.92 / $9.92	Professional	52	$9.92	$9.92	$9.92
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $27.77 / $48.27	Professional	TC	$19.64	$27.77	$48.27
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 $24.69 / $33.67 / $59.74	Professional		$24.69	$33.67	$59.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.04 / $9.52 / $16.82	Professional	26	$7.04	$9.52	$16.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.54 / $23.41 / $42.96	Professional	TC	$15.54	$23.41	$42.96