Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.11 / $227.61 / $512.66	Facility		$62.11	$227.61	$512.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $11.63 / $28.86	Facility	26	$8.13	$11.63	$28.86
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.35 / $306.44 / $667.40	Facility	TC	$38.35	$306.44	$667.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.89 / $35.46 / $87.55	Professional		$11.89	$35.46	$87.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.77 / $12.99 / $35.46	Professional	26	$7.77	$12.99	$35.46
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.73 / $28.48 / $286.55	Professional	50	$17.73	$28.48	$286.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.34 / $16.97 / $30.08	Professional	52	$12.34	$16.97	$30.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $31.50 / $57.06	Professional	TC	$21.94	$31.50	$57.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $28.56 / $60.00	Professional		$23.62	$28.56	$60.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.32 / $9.28 / $14.53	Professional	26	$6.32	$9.28	$14.53
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $37.20 / $37.20 / $42.84	Professional	50	$37.20	$37.20	$42.84
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.54 / $25.29 / $38.42	Professional	TC	$20.54	$25.29	$38.42
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 $26.98 / $33.32 / $55.87	Professional		$26.98	$33.32	$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 $40.47 / $50.46 / $83.80	Professional	50	$40.47	$50.46	$83.80
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.18 / $23.83 / $40.00	Professional	TC	$18.18	$23.83	$40.00
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $38.57 / $42.50 / $59.82	Professional		$38.57	$42.50	$59.82
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.32 / $10.27 / $14.46	Professional	26	$9.32	$10.27	$14.46
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $32.22 / $45.37	Professional	TC	$29.25	$32.22	$45.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.69 / $29.75 / $44.13	Facility		$8.69	$29.75	$44.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.69 / $31.14 / $45.77	Professional		$8.69	$31.14	$45.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.44 / $166.60 / $268.55	Facility		$45.44	$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 / $31.68 / $31.68	Facility	TC	$26.72	$31.68	$31.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.97 / $42.43 / $78.91	Professional		$28.97	$42.43	$78.91
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 $21.65 / $30.98 / $56.39	Professional	TC	$21.65	$30.98	$56.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $104.35 / $251.52 / $399.00	Facility		$104.35	$251.52	$399.00
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $10.31	Facility	26	$9.61	$9.61	$10.31
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $26.72 / $195.73 / $647.58	Facility	TC	$26.72	$195.73	$647.58
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $27.04 / $42.49 / $79.31	Professional		$27.04	$42.49	$79.31
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $13.15 / $25.74	Professional	26	$8.15	$13.15	$25.74
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $22.48 / $32.22 / $60.32	Professional	TC	$22.48	$32.22	$60.32
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 / $67.75	Facility		$9.86	$28.03	$67.75
United Facility/Professional Professional Modifier Low / Median / High Price $26.60 / $37.04 / $67.20	Professional		$26.60	$37.04	$67.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $9.98 / $17.54	Professional	26	$7.24	$9.98	$17.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $28.06 / $48.16	Professional	TC	$18.32	$28.06	$48.16