Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.87 / $165.41 / $400.44	Facility		$45.87	$165.41	$400.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $12.10 / $30.04	Facility	26	$8.46	$12.10	$30.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.87 / $220.90 / $389.16	Facility	TC	$25.87	$220.90	$389.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.69 / $31.76 / $78.83	Professional		$24.69	$31.76	$78.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $11.42 / $24.08	Professional	26	$8.08	$11.42	$24.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $20.79 / $41.87	Professional	TC	$16.60	$20.79	$41.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.69 / $22.44 / $36.78	Professional		$21.69	$22.44	$36.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $10.52 / $15.12	Professional	26	$6.45	$10.52	$15.12
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.65 / $22.55 / $29.30	Professional	TC	$15.65	$22.55	$29.30
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 $24.96 / $31.15 / $52.88	Professional		$24.96	$31.15	$52.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $10.22 / $18.13	Professional	26	$8.73	$10.22	$18.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.13 / $20.58 / $34.76	Professional	TC	$16.13	$20.58	$34.76
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $35.26 / $49.63	Professional		$32.00	$35.26	$49.63
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $10.69 / $15.04	Professional	26	$9.69	$10.69	$15.04
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $22.30 / $24.57 / $34.59	Professional	TC	$22.30	$24.57	$34.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.03 / $22.68 / $36.61	Facility		$9.03	$22.68	$36.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.03 / $23.69 / $37.97	Professional		$9.03	$23.69	$37.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.92 / $173.99 / $268.55	Facility		$33.92	$173.99	$268.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.74	Facility	26	$10.01	$10.01	$10.74
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $20.88 / $24.24 / $24.24	Facility	TC	$20.88	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.53 / $36.03 / $62.37	Professional		$24.53	$36.03	$62.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $11.62 / $19.60	Professional	26	$7.43	$11.62	$19.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $24.39 / $44.96	Professional	TC	$17.05	$24.39	$44.96
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $95.56 / $202.85 / $337.62	Facility		$95.56	$202.85	$337.62
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.74	Facility	26	$10.01	$10.01	$10.74
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $265.60 / $360.23	Facility	TC	$24.24	$265.60	$360.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.13 / $35.39 / $75.93	Professional		$24.13	$35.39	$75.93
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.15 / $25.38	Professional	26	$8.32	$13.15	$25.38
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $17.34 / $24.54 / $42.33	Professional	TC	$17.34	$24.54	$42.33
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 $21.15 / $31.98 / $55.30	Professional		$21.15	$31.98	$55.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $10.69 / $20.64	Professional	26	$7.65	$10.69	$20.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.13 / $20.96 / $37.99	Professional	TC	$16.13	$20.96	$37.99