Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.41 / $193.23 / $417.55	Facility		$45.41	$193.23	$417.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.99 / $47.50 / $112.90	Facility	26	$28.99	$47.50	$112.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.41 / $81.11 / $158.29	Professional		$45.41	$81.11	$158.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $45.34 / $112.90	Professional	26	$28.22	$45.34	$112.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $82.23 / $179.00 / $225.00	Professional	50	$82.23	$179.00	$225.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.17 / $28.16 / $50.14	Professional	TC	$16.17	$28.16	$50.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.56 / $29.56 / $29.56	Professional		$29.56	$29.56	$29.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $246.06 / $260.52 / $297.37	Facility		$246.06	$260.52	$297.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $97.66 / $161.51	Professional		$56.97	$97.66	$161.51
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.56 / $54.22 / $99.00	Professional	26	$36.56	$54.22	$99.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $85.46 / $147.90 / $242.27	Professional	50	$85.46	$147.90	$242.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.86 / $41.82 / $68.53	Professional	TC	$22.86	$41.82	$68.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $17.07 / $33.79 / $59.17	Facility		$17.07	$33.79	$59.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.23 / $36.10 / $61.36	Professional		$17.23	$36.10	$61.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.09 / $218.77 / $405.93	Facility		$99.09	$218.77	$405.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.02 / $88.44 / $161.49	Professional		$46.02	$88.44	$161.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.20 / $47.89 / $89.62	Professional	26	$28.20	$47.89	$89.62
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.23 / $79.23 / $90.51	Professional	50	$79.23	$79.23	$90.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.88 / $35.07 / $76.42	Professional	TC	$16.88	$35.07	$76.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $103.66 / $214.04 / $504.00	Facility		$103.66	$214.04	$504.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $46.94 / $82.59 / $169.03	Professional		$46.94	$82.59	$169.03
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $28.66 / $46.48 / $91.54	Professional	26	$28.66	$46.48	$91.54
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $17.22 / $28.26 / $73.34	Professional	TC	$17.22	$28.26	$73.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $48.31 / $88.82	Professional		$29.46	$48.31	$88.82
United Facility/Professional Professional Modifier Low / Median / High Price $46.94 / $67.59 / $119.26	Professional		$46.94	$67.59	$119.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.67 / $38.54 / $61.03	Professional	26	$28.67	$38.54	$61.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.97 / $25.52 / $56.24	Professional	TC	$17.97	$25.52	$56.24