Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $15.49 / $33.88	Facility	26	$11.48	$15.49	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $45.71 / $120.23	Professional		$33.11	$45.71	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.98 / $40.74	Professional	26	$10.00	$16.98	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $32.36 / $72.44	Professional	TC	$22.91	$32.36	$72.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $35.48	Professional		$35.48	$35.48	$35.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.22 / $20.42	Professional	26	$8.91	$11.22	$20.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $43.65 / $70.79	Professional		$33.11	$43.65	$70.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.60 / $26.30	Professional	26	$12.59	$16.60	$26.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.92 / $45.71	Professional	TC	$19.50	$26.92	$45.71
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $48.98 / $52.48	Professional		$46.77	$48.98	$52.48
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.13 / $14.79	Professional	26	$13.49	$14.13	$14.79
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $35.48 / $37.15	Professional	TC	$33.11	$35.48	$37.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.95 / $13.80 / $19.50	Facility	26	$2.95	$13.80	$19.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $50.12 / $91.20	Professional		$33.88	$50.12	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.85 / $26.92	Professional	26	$10.72	$15.85	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $66.07	Professional	TC	$23.99	$35.48	$66.07
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $2.95 / $13.80 / $19.50	Facility	26	$2.95	$13.80	$19.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $48.98 / $91.20	Professional		$33.88	$48.98	$91.20
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $16.22 / $31.62	Professional	26	$10.72	$16.22	$31.62
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $35.48 / $66.07	Professional	TC	$23.99	$35.48	$66.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $32.36 / $33.11	Professional		$19.50	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $93.33	Professional		$41.69	$52.48	$93.33
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $14.79 / $26.30	Professional	26	$12.02	$14.79	$26.30
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $37.15 / $67.61	Professional	TC	$30.20	$37.15	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $72.44	Professional		$32.36	$42.66	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.49 / $23.44	Professional	26	$10.00	$13.49	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $29.51 / $51.29	Professional	TC	$21.88	$29.51	$51.29