Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.18 / $94.39 / $224.35	Facility	26	$67.18	$94.39	$224.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.00 / $322.58 / $746.58	Professional		$132.00	$322.58	$746.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.43 / $114.91 / $238.44	Professional	26	$65.43	$114.91	$238.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $475.94 / $475.94 / $475.94	Professional	50	$475.94	$475.94	$475.94
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $104.19 / $125.00 / $262.50	Professional	52	$104.19	$125.00	$262.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $142.22 / $259.35 / $557.00	Professional	TC	$142.22	$259.35	$557.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.66 / $155.22 / $187.05	Professional		$134.66	$155.22	$187.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.33 / $68.22 / $105.72	Professional	26	$48.33	$68.22	$105.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $104.65 / $121.45 / $142.49	Professional	TC	$104.65	$121.45	$142.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $242.27 / $334.45 / $653.94	Professional		$242.27	$334.45	$653.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.01 / $76.38 / $140.60	Professional	26	$61.01	$76.38	$140.60
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $363.20 / $494.52 / $981.48	Professional	50	$363.20	$494.52	$981.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $170.56 / $260.00 / $501.80	Professional	TC	$170.56	$260.00	$501.80
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $220.25 / $242.65 / $242.65	Professional		$220.25	$242.65	$242.65
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $71.28 / $78.53 / $78.53	Professional	26	$71.28	$78.53	$78.53
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $148.96 / $164.11 / $164.11	Professional	TC	$148.96	$164.11	$164.11
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $159.03 / $269.99	Professional		$66.45	$159.03	$269.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.73 / $73.64 / $73.64	Facility	26	$66.73	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.74 / $343.14 / $713.09	Professional		$196.74	$343.14	$713.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.99 / $86.02 / $146.88	Professional	26	$55.99	$86.02	$146.88
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $301.29 / $301.29 / $301.29	Professional	50	$301.29	$301.29	$301.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.75 / $234.83 / $620.03	Professional	TC	$134.75	$234.83	$620.03
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $66.73 / $66.73 / $73.64	Facility	26	$66.73	$66.73	$73.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $185.39 / $337.01 / $700.00	Professional		$185.39	$337.01	$700.00
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $63.43 / $98.22 / $186.74	Professional	26	$63.43	$98.22	$186.74
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $429.85 / $429.85 / $429.85	Professional	50	$429.85	$429.85	$429.85
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $138.86 / $221.46 / $558.61	Professional	TC	$138.86	$221.46	$558.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.67 / $141.83 / $254.26	Professional		$65.67	$141.83	$254.26
United Facility/Professional Professional Modifier Low / Median / High Price $202.21 / $279.08 / $581.04	Professional		$202.21	$279.08	$581.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.46 / $74.83 / $136.24	Professional	26	$56.46	$74.83	$136.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.87 / $187.60 / $449.96	Professional	TC	$138.87	$187.60	$449.96