Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.69 / $453.79 / $918.88	Facility		$118.69	$453.79	$918.88
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.97 / $22.88 / $54.38	Facility	26	$14.97	$22.88	$54.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $96.33 / $200.96	Professional		$81.59	$96.33	$200.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.52 / $15.62 / $54.38	Professional	26	$13.52	$15.62	$54.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.40 / $80.70 / $162.19	Professional	TC	$67.40	$80.70	$162.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.29 / $190.29 / $190.29	Professional		$190.29	$190.29	$190.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.47 / $11.53 / $24.83	Professional	26	$8.47	$11.53	$24.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $520.04 / $550.62 / $628.50	Facility		$520.04	$550.62	$628.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.15 / $88.98 / $152.93	Professional		$63.15	$88.98	$152.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.85 / $19.14 / $35.18	Professional	26	$16.85	$19.14	$35.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.30 / $67.08 / $118.68	Professional	TC	$46.30	$67.08	$118.68
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $106.92 / $106.92 / $117.79	Professional		$106.92	$106.92	$117.79
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $17.16 / $17.16 / $18.89	Professional	26	$17.16	$17.16	$18.89
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $89.76 / $89.76 / $98.89	Professional	TC	$89.76	$89.76	$98.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.83 / $77.59 / $134.58	Facility		$14.83	$77.59	$134.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.99 / $83.68 / $99.67	Professional		$15.99	$83.68	$99.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $122.66 / $467.66 / $798.46	Facility		$122.66	$467.66	$798.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $19.39	Facility	26	$17.75	$17.75	$19.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $115.74 / $211.25	Professional		$77.84	$115.74	$211.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.57 / $20.59 / $34.78	Professional	26	$13.57	$20.59	$34.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.83 / $94.90 / $170.39	Professional	TC	$65.83	$94.90	$170.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $179.17 / $497.35 / $963.19	Facility		$179.17	$497.35	$963.19
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $19.39	Facility	26	$17.75	$17.75	$19.39
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $116.69 / $201.77	Professional		$76.23	$116.69	$201.77
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $14.74 / $21.13 / $35.35	Professional	26	$14.74	$21.13	$35.35
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $69.31 / $97.69 / $164.14	Professional	TC	$69.31	$97.69	$164.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $79.56 / $108.74 / $153.23	Professional		$79.56	$108.74	$153.23
United Facility/Professional Facility Modifier Low / Median / High Price $68.98 / $181.58 / $194.14	Facility		$68.98	$181.58	$194.14
United Facility/Professional Professional Modifier Low / Median / High Price $71.91 / $101.66 / $187.89	Professional		$71.91	$101.66	$187.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.32 / $18.30 / $32.40	Professional	26	$13.32	$18.30	$32.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.44 / $82.29 / $150.25	Professional	TC	$59.44	$82.29	$150.25