Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $18.20 / $45.71	Facility	26	$12.88	$18.20	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $50.12 / $144.54	Professional		$38.02	$50.12	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.98 / $47.86	Professional	26	$10.96	$16.98	$47.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $34.67 / $87.10	Professional	TC	$25.12	$34.67	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.47 / $12.59 / $21.88	Professional	26	$4.47	$12.59	$21.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $51.29 / $81.28	Professional		$38.90	$51.29	$81.28
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.62 / $28.84	Professional	26	$14.13	$18.62	$28.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $32.36 / $53.70	Professional	TC	$23.99	$32.36	$53.70
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $53.70	Professional		$51.29	$51.29	$53.70
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $14.79 / $15.49	Professional	26	$14.79	$14.79	$15.49
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $35.48 / $38.02	Professional	TC	$35.48	$35.48	$38.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.24 / $15.14 / $21.88	Facility	26	$3.24	$15.14	$21.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $58.88 / $97.72	Professional		$38.02	$58.88	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $17.78 / $30.20	Professional	26	$12.02	$17.78	$30.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $39.81 / $72.44	Professional	TC	$26.30	$39.81	$72.44
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $3.24 / $15.14 / $21.88	Facility	26	$3.24	$15.14	$21.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $54.95 / $104.71	Professional		$37.15	$54.95	$104.71
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $17.78 / $30.90	Professional	26	$11.48	$17.78	$30.90
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $38.90 / $72.44	Professional	TC	$26.30	$38.90	$72.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $32.36 / $33.11	Professional		$21.38	$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 $45.71 / $57.54 / $102.33	Professional		$45.71	$57.54	$102.33
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.60 / $29.51	Professional	26	$13.49	$16.60	$29.51
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $40.74 / $72.44	Professional	TC	$32.36	$40.74	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $46.77 / $81.28	Professional		$36.31	$46.77	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $14.79 / $25.70	Professional	26	$11.22	$14.79	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $32.36 / $56.23	Professional	TC	$24.55	$32.36	$56.23