Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.52 / $273.64 / $896.12	Facility		$68.52	$273.64	$896.12
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.10 / $48.15 / $111.31	Facility	26	$29.10	$48.15	$111.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.80 / $93.34 / $329.52	Professional		$52.80	$93.34	$329.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.57 / $40.03 / $115.12	Professional	26	$28.57	$40.03	$115.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $37.04 / $187.42	Professional	TC	$24.75	$37.04	$187.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.19 / $45.84 / $84.07	Professional		$39.19	$45.84	$84.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.85 / $30.00 / $42.50	Professional	26	$22.85	$30.00	$42.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.70 / $82.27 / $93.90	Facility		$77.70	$82.27	$93.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.51 / $108.78 / $185.62	Professional		$70.51	$108.78	$185.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.18 / $40.17 / $62.71	Professional	26	$32.18	$40.17	$62.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.40 / $66.56 / $117.86	Professional	TC	$33.40	$66.56	$117.86
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $64.00 / $64.00 / $86.24	Professional		$64.00	$64.00	$86.24
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $33.71 / $33.71 / $45.43	Professional	26	$33.71	$33.71	$45.43
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $30.30 / $30.30 / $40.83	Professional	TC	$30.30	$30.30	$40.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.85 / $38.14 / $73.22	Facility		$26.85	$38.14	$73.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.23 / $38.72 / $74.09	Professional		$28.23	$38.72	$74.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.60 / $111.90 / $111.90	Facility		$104.60	$111.90	$111.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.28 / $88.12 / $256.58	Professional		$51.28	$88.12	$256.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.00 / $41.02 / $66.02	Professional	26	$28.00	$41.02	$66.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.29 / $41.99 / $210.14	Professional	TC	$22.29	$41.99	$210.14
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $162.08 / $566.10 / $983.69	Facility		$162.08	$566.10	$983.69
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $51.53 / $87.01 / $256.58	Professional		$51.53	$87.01	$256.58
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $28.89 / $42.77 / $79.54	Professional	26	$28.89	$42.77	$79.54
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $23.52 / $39.10 / $213.47	Professional	TC	$23.52	$39.10	$213.47
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 $49.84 / $69.50 / $191.36	Professional		$49.84	$69.50	$191.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $36.52 / $57.33	Professional	26	$26.96	$36.52	$57.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.93 / $30.51 / $141.26	Professional	TC	$21.93	$30.51	$141.26