Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.67 / $19.39 / $46.12	Facility	26	$12.67	$19.39	$46.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.73 / $62.82 / $80.19	Facility	TC	$26.73	$62.82	$80.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.84 / $39.39 / $74.61	Professional		$34.84	$39.39	$74.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $12.92 / $23.62	Professional	26	$11.23	$12.92	$23.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.75 / $26.73 / $50.15	Professional	TC	$22.75	$26.73	$50.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.95 / $32.95 / $39.88	Professional		$32.95	$32.95	$39.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $9.85 / $16.00	Professional	26	$9.74	$9.85	$16.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $44.50 / $74.01	Professional		$36.28	$44.50	$74.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.53 / $15.62 / $27.83	Professional	26	$13.53	$15.62	$27.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.96 / $28.23 / $47.17	Professional	TC	$22.96	$28.23	$47.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.54 / $28.25 / $41.79	Professional		$13.54	$28.25	$41.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $16.57	Facility	26	$15.00	$15.00	$16.57
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.89 / $32.79 / $32.79	Facility	TC	$27.89	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $51.29 / $87.91	Professional		$34.72	$51.29	$87.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.20 / $17.43 / $29.58	Professional	26	$11.20	$17.43	$29.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $33.36 / $60.84	Professional	TC	$23.08	$33.36	$60.84
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $16.57	Facility	26	$15.00	$15.00	$16.57
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $27.89 / $32.79 / $197.89	Facility	TC	$27.89	$32.79	$197.89
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $36.09 / $51.29 / $85.09	Professional		$36.09	$51.29	$85.09
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $12.45 / $17.70 / $34.43	Professional	26	$12.45	$17.70	$34.43
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $24.20 / $33.38 / $57.51	Professional	TC	$24.20	$33.38	$57.51
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 $30.17 / $43.79 / $78.23	Professional		$30.17	$43.79	$78.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.93 / $16.36 / $29.69	Professional	26	$11.93	$16.36	$29.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.16 / $29.80 / $52.80	Professional	TC	$22.16	$29.80	$52.80