Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.80 / $198.00 / $397.44	Facility		$46.80	$198.00	$397.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.19 / $10.06 / $25.52	Facility	26	$7.19	$10.06	$25.52
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.47 / $246.28 / $612.88	Facility	TC	$25.47	$246.28	$612.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $28.15 / $57.16	Professional		$16.20	$28.15	$57.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.71 / $10.15 / $29.04	Professional	26	$6.71	$10.15	$29.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $83.80 / $83.80 / $83.80	Professional	50	$83.80	$83.80	$83.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.10 / $13.32 / $23.43	Professional	52	$10.10	$13.32	$23.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $21.01 / $41.23	Professional	TC	$17.05	$21.01	$41.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.30 / $21.20 / $28.53	Professional		$16.30	$21.20	$28.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.59 / $8.19 / $11.57	Professional	26	$5.59	$8.19	$11.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.13 / $28.83 / $28.83	Professional	TC	$16.13	$28.83	$28.83
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 / $29.70 / $51.25	Professional		$24.66	$29.70	$51.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.81 / $9.49 / $17.47	Professional	26	$7.81	$9.49	$17.47
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.99 / $44.92 / $77.61	Professional	50	$36.99	$44.92	$77.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.26 / $20.07 / $33.97	Professional	TC	$16.26	$20.07	$33.97
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.24 / $8.24 / $8.24	Professional	26	$8.24	$8.24	$8.24
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $21.95 / $21.95 / $21.95	Professional	TC	$21.95	$21.95	$21.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.67 / $22.32 / $34.54	Facility		$7.67	$22.32	$34.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.68 / $23.31 / $35.83	Professional		$7.68	$23.31	$35.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.86 / $162.54 / $268.55	Facility		$35.86	$162.54	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $8.51 / $9.10	Facility	26	$8.51	$8.51	$9.10
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $20.88 / $23.86 / $23.86	Facility	TC	$20.88	$23.86	$23.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.47 / $34.83 / $60.84	Professional		$23.47	$34.83	$60.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $9.81 / $16.44	Professional	26	$6.47	$9.81	$16.44
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.13 / $35.13 / $35.13	Professional	50	$35.13	$35.13	$35.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $24.73 / $44.04	Professional	TC	$17.05	$24.73	$44.04
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $64.38 / $195.61 / $350.32	Facility		$64.38	$195.61	$350.32
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $8.51 / $9.10	Facility	26	$8.51	$8.51	$9.10
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $20.88 / $30.62 / $359.35	Facility	TC	$20.88	$30.62	$359.35
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $23.16 / $34.15 / $57.85	Professional		$23.16	$34.15	$57.85
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.55 / $19.89	Professional	26	$7.08	$10.55	$19.89
Medical Mutual of Ohio Facility/Professional Professional Modifier 52 Low / Median / High Price $18.14 / $18.14 / $46.28	Professional	52	$18.14	$18.14	$46.28
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $17.61 / $25.11 / $42.03	Professional	TC	$17.61	$25.11	$42.03
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 $22.92 / $30.79 / $53.36	Professional		$22.92	$30.79	$53.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.37 / $8.80 / $15.50	Professional	26	$6.37	$8.80	$15.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.15 / $21.69 / $37.97	Professional	TC	$15.15	$21.69	$37.97