Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.28 / $99.63 / $728.40	Facility		$50.28	$99.63	$728.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.44 / $23.87 / $62.43	Facility	26	$13.44	$23.87	$62.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.49 / $37.56 / $70.62	Professional		$31.49	$37.56	$70.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $17.01 / $48.25	Professional	26	$12.75	$17.01	$48.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.52 / $22.52 / $44.28	Professional	TC	$19.52	$22.52	$44.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.85 / $29.08 / $71.31	Professional		$28.85	$29.08	$71.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $13.53 / $20.07	Professional	26	$10.18	$13.53	$20.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.80 / $77.08 / $87.98	Facility		$72.80	$77.08	$87.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.58 / $38.09 / $60.13	Professional		$30.58	$38.09	$60.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.24 / $17.38 / $27.77	Professional	26	$14.24	$17.38	$27.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.34 / $20.76 / $35.27	Professional	TC	$16.34	$20.76	$35.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.00 / $26.57 / $47.07	Facility		$14.00	$26.57	$47.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.00 / $28.78 / $48.82	Professional		$14.00	$28.78	$48.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.19 / $59.04 / $59.04	Facility		$55.19	$59.04	$59.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.19 / $46.19 / $74.23	Professional		$31.19	$46.19	$74.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.73 / $18.48 / $29.76	Professional	26	$12.73	$18.48	$29.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $27.34 / $45.39	Professional	TC	$17.89	$27.34	$45.39
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $66.98 / $246.55 / $567.47	Facility		$66.98	$246.55	$567.47
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $30.76 / $46.28 / $73.23	Professional		$30.76	$46.28	$73.23
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $13.39 / $19.46 / $31.67	Professional	26	$13.39	$19.46	$31.67
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $18.84 / $27.68 / $45.39	Professional	TC	$18.84	$27.68	$45.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.29 / $36.29 / $51.07	Professional		$26.29	$36.29	$51.07
United Facility/Professional Professional Modifier Low / Median / High Price $29.06 / $38.88 / $63.19	Professional		$29.06	$38.88	$63.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $16.69 / $25.48	Professional	26	$12.28	$16.69	$25.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.27 / $22.93 / $35.82	Professional	TC	$16.27	$22.93	$35.82