Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.00 / $18.59 / $46.22	Facility	26	$13.00	$18.59	$46.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.42 / $46.20 / $92.89	Professional		$39.42	$46.20	$92.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.54 / $13.30 / $28.26	Professional	26	$11.54	$13.30	$28.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $33.04 / $64.50	Professional	TC	$27.69	$33.04	$64.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.34 / $37.34 / $37.34	Professional		$37.34	$37.34	$37.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.75 / $12.68 / $19.02	Professional	26	$3.75	$12.68	$19.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.20 / $46.55 / $79.70	Professional		$35.20	$46.55	$79.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.00 / $16.48 / $28.86	Professional	26	$14.00	$16.48	$28.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.20 / $30.39 / $52.03	Professional	TC	$21.20	$30.39	$52.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.89 / $33.43 / $47.32	Professional		$13.89	$33.43	$47.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $16.62	Facility	26	$15.41	$15.41	$16.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.32 / $57.94 / $102.37	Professional		$39.32	$57.94	$102.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.79 / $17.91 / $30.35	Professional	26	$11.79	$17.91	$30.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.42 / $39.44 / $70.25	Professional	TC	$27.42	$39.44	$70.25
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $16.62	Facility	26	$15.41	$15.41	$16.62
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $57.35 / $96.37	Professional		$39.79	$57.35	$96.37
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $18.16 / $29.05	Professional	26	$12.78	$18.16	$29.05
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $28.54 / $39.51 / $68.08	Professional	TC	$28.54	$39.51	$68.08
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 $37.67 / $51.37 / $87.82	Professional		$37.67	$51.37	$87.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.12 / $15.92 / $27.62	Professional	26	$11.12	$15.92	$27.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.29 / $34.96 / $60.01	Professional	TC	$25.29	$34.96	$60.01