Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.06 / $17.00 / $40.40	Facility	26	$11.06	$17.00	$40.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.78 / $49.99 / $95.85	Professional		$43.78	$49.99	$95.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $11.28 / $21.78	Professional	26	$9.78	$11.28	$21.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.15 / $37.95 / $72.16	Professional	TC	$33.15	$37.95	$72.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $41.47 / $41.47	Professional		$36.29	$41.47	$41.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $13.98 / $13.98	Professional	26	$8.48	$13.98	$13.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.00 / $49.24 / $83.53	Professional		$36.00	$49.24	$83.53
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.40 / $25.55	Professional	26	$12.30	$14.40	$25.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.70 / $34.15 / $60.02	Professional	TC	$23.70	$34.15	$60.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.83 / $40.56 / $52.38	Professional		$11.83	$40.56	$52.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.10 / $13.10 / $14.50	Facility	26	$13.10	$13.10	$14.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.20 / $63.39 / $115.19	Professional		$42.20	$63.39	$115.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $15.22 / $25.89	Professional	26	$10.03	$15.22	$25.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $47.29 / $86.02	Professional	TC	$32.79	$47.29	$86.02
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $13.10 / $13.10 / $14.50	Facility	26	$13.10	$13.10	$14.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $43.22 / $62.44 / $106.68	Professional		$43.22	$62.44	$106.68
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $15.59 / $25.83	Professional	26	$10.89	$15.59	$25.83
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $33.45 / $47.66 / $82.60	Professional	TC	$33.45	$47.66	$82.60
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 $40.54 / $56.52 / $97.14	Professional		$40.54	$56.52	$97.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $13.65 / $24.61	Professional	26	$9.86	$13.65	$24.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.50 / $40.35 / $74.91	Professional	TC	$29.50	$40.35	$74.91