Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.16 / $11.67 / $27.78	Facility	26	$8.16	$11.67	$27.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.73 / $30.94 / $57.53	Professional		$21.73	$30.94	$57.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.98 / $24.03	Professional	26	$7.33	$8.98	$24.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.96 / $36.94 / $36.94	Professional	50	$28.96	$36.94	$36.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $22.59 / $43.69	Professional	TC	$18.53	$22.59	$43.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.73 / $22.73 / $54.38	Professional		$22.73	$22.73	$54.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.58 / $12.39 / $15.12	Professional	26	$6.58	$12.39	$15.12
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $25.87 / $25.87 / $25.87	Professional	50	$25.87	$25.87	$25.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $28.88 / $49.50	Professional		$20.50	$28.88	$49.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.80 / $10.34 / $18.11	Professional	26	$8.80	$10.34	$18.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $30.75 / $42.29 / $74.25	Professional	50	$30.75	$42.29	$74.25
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $11.70 / $17.23 / $31.77	Professional	TC	$11.70	$17.23	$31.77
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $35.13 / $35.13 / $35.13	Professional		$35.13	$35.13	$35.13
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $9.69 / $9.69	Professional	26	$9.69	$9.69	$9.69
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $25.43 / $25.43 / $25.43	Professional	TC	$25.43	$25.43	$25.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.03 / $27.04 / $41.68	Professional		$9.03	$27.04	$41.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.92	Facility	26	$9.67	$9.67	$9.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.30 / $37.93 / $69.58	Professional		$25.30	$37.93	$69.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $11.40 / $18.41	Professional	26	$7.36	$11.40	$18.41
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.29 / $38.29 / $38.29	Professional	50	$38.29	$38.29	$38.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.25 / $26.57 / $49.03	Professional	TC	$18.25	$26.57	$49.03
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $9.67 / $9.67 / $9.92	Facility	26	$9.67	$9.67	$9.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.95 / $37.93 / $65.00	Professional		$24.95	$37.93	$65.00
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $11.72 / $19.76	Professional	26	$8.02	$11.72	$19.76
Medical Mutual of Ohio Facility/Professional Professional Modifier 50 Low / Median / High Price $12.71 / $12.71 / $12.71	Professional	50	$12.71	$12.71	$12.71
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $26.94 / $48.27	Professional	TC	$19.14	$26.94	$48.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $36.24 / $51.07	Professional		$26.52	$36.24	$51.07
United Facility/Professional Professional Modifier Low / Median / High Price $22.94 / $32.74 / $59.66	Professional		$22.94	$32.74	$59.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.12 / $9.96 / $17.32	Professional	26	$7.12	$9.96	$17.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.58 / $23.77 / $43.21	Professional	TC	$14.58	$23.77	$43.21