Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.00 / $21.51 / $57.73	Facility	26	$13.00	$21.51	$57.73
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.58 / $85.65 / $530.16	Facility	TC	$32.58	$85.65	$530.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $46.23 / $79.50	Professional		$37.04	$46.23	$79.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $15.33 / $46.56	Professional	26	$12.52	$15.33	$46.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.64 / $31.62 / $56.24	Professional	TC	$25.64	$31.62	$56.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.15 / $33.29 / $35.02	Professional		$33.15	$33.29	$35.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $10.30 / $17.46	Professional	26	$10.11	$10.30	$17.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.30 / $52.40 / $91.98	Professional		$43.30	$52.40	$91.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.86 / $19.07 / $36.13	Professional	26	$15.86	$19.07	$36.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.13 / $32.75 / $56.04	Professional	TC	$26.13	$32.75	$56.04
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $52.48	Professional		$52.48	$52.48	$52.48
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $16.42 / $16.42 / $16.42	Professional	26	$16.42	$16.42	$16.42
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $36.06 / $36.06 / $36.06	Professional	TC	$36.06	$36.06	$36.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.89 / $30.51 / $44.41	Professional		$13.89	$30.51	$44.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $20.61	Facility	26	$15.41	$15.41	$20.61
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.57 / $35.04 / $35.04	Facility	TC	$32.57	$35.04	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $58.18 / $101.08	Professional		$38.54	$58.18	$101.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.63 / $19.11 / $31.75	Professional	26	$12.63	$19.11	$31.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.26 / $39.06 / $65.48	Professional	TC	$25.26	$39.06	$65.48
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $20.61	Facility	26	$15.41	$15.41	$20.61
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $32.57 / $32.57 / $35.04	Facility	TC	$32.57	$32.57	$35.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $56.52 / $97.05	Professional		$39.47	$56.52	$97.05
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $18.95 / $31.75	Professional	26	$13.07	$18.95	$31.75
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $26.08 / $38.83 / $64.91	Professional	TC	$26.08	$38.83	$64.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.98 / $36.24 / $51.07	Professional		$26.98	$36.24	$51.07
United Facility/Professional Professional Modifier Low / Median / High Price $34.86 / $50.02 / $86.98	Professional		$34.86	$50.02	$86.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.58 / $17.34 / $32.56	Professional	26	$12.58	$17.34	$32.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.96 / $32.65 / $57.01	Professional	TC	$23.96	$32.65	$57.01