Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.09 / $14.43 / $41.59	Facility	26	$10.09	$14.43	$41.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.50 / $38.92 / $74.20	Professional		$31.50	$38.92	$74.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.49 / $11.47 / $33.77	Professional	26	$9.49	$11.47	$33.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.37 / $27.69 / $52.81	Professional	TC	$22.37	$27.69	$52.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.01 / $28.10 / $35.74	Professional		$22.01	$28.10	$35.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $10.29 / $16.26	Professional	26	$7.85	$10.29	$16.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.93 / $28.93 / $28.93	Professional	TC	$28.93	$28.93	$28.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.89 / $42.68 / $74.20	Professional		$35.89	$42.68	$74.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.06 / $14.32 / $25.60	Professional	26	$12.06	$14.32	$25.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.29 / $28.64 / $48.51	Professional	TC	$23.29	$28.64	$48.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.79 / $30.39 / $47.61	Professional		$10.79	$30.39	$47.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $14.94	Facility	26	$11.95	$11.95	$14.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $48.54 / $84.03	Professional		$32.00	$48.54	$84.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $14.23 / $24.24	Professional	26	$9.66	$14.23	$24.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.02 / $33.97 / $57.35	Professional	TC	$22.02	$33.97	$57.35
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $14.94	Facility	26	$11.95	$11.95	$14.94
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $47.62 / $81.78	Professional		$33.04	$47.62	$81.78
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $15.15 / $28.15	Professional	26	$10.02	$15.15	$28.15
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $22.32 / $33.88 / $55.85	Professional	TC	$22.32	$33.88	$55.85
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 $29.73 / $40.81 / $72.56	Professional		$29.73	$40.81	$72.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.24 / $13.24 / $22.52	Professional	26	$9.24	$13.24	$22.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $27.93 / $49.07	Professional	TC	$19.57	$27.93	$49.07