Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.12 / $201.98 / $410.78	Facility		$49.12	$201.98	$410.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $26.23 / $64.94	Facility	26	$17.36	$26.23	$64.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.38 / $80.13 / $321.24	Facility	TC	$13.38	$80.13	$321.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.74 / $60.32 / $99.80	Professional		$30.74	$60.32	$99.80
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $71.59 / $71.59 / $71.59	Professional	25	$71.59	$71.59	$71.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.36 / $24.48 / $61.08	Professional	26	$17.36	$24.48	$61.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $234.74 / $234.74 / $281.35	Professional	50	$234.74	$234.74	$281.35
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.37 / $19.72 / $42.11	Professional	52	$15.37	$19.72	$42.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.38 / $25.38 / $66.91	Professional	TC	$13.38	$25.38	$66.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.29 / $35.78 / $45.95	Professional		$31.29	$35.78	$45.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.45 / $68.27 / $125.89	Professional		$41.45	$68.27	$125.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $23.76 / $44.11	Professional	26	$18.60	$23.76	$44.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $62.17 / $102.40 / $189.44	Professional	50	$62.17	$102.40	$189.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $44.17 / $83.48	Professional	TC	$18.82	$44.17	$83.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.93 / $23.96 / $45.95	Facility		$15.93	$23.96	$45.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.93 / $24.92 / $46.28	Professional		$15.93	$24.92	$46.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.38 / $41.38 / $64.25	Facility		$41.38	$41.38	$64.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $28.92	Facility	26	$23.35	$23.35	$28.92
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.64 / $18.64 / $35.32	Facility	TC	$18.64	$18.64	$35.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.90 / $62.99 / $123.47	Professional		$33.90	$62.99	$123.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.21 / $27.54 / $43.37	Professional	26	$18.21	$27.54	$43.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.74 / $31.47 / $80.34	Professional	TC	$14.74	$31.47	$80.34
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $69.86 / $150.09 / $292.29	Facility		$69.86	$150.09	$292.29
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $28.92	Facility	26	$23.35	$23.35	$28.92
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $18.64 / $18.64 / $35.32	Facility	TC	$18.64	$18.64	$35.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $36.77 / $60.56 / $122.88	Professional		$36.77	$60.56	$122.88
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $18.85 / $27.61 / $42.98	Professional	26	$18.85	$27.61	$42.98
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $15.93 / $26.25 / $77.19	Professional	TC	$15.93	$26.25	$77.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $35.51 / $50.72	Professional		$27.10	$35.51	$50.72
United Facility/Professional Professional Modifier Low / Median / High Price $38.93 / $55.00 / $112.90	Professional		$38.93	$55.00	$112.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.64 / $23.77 / $44.97	Professional	26	$18.64	$23.77	$44.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.01 / $31.03 / $67.58	Professional	TC	$19.01	$31.03	$67.58