Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.00 / $22.30 / $53.00	Facility	26	$14.00	$22.30	$53.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.55 / $67.09 / $85.65	Facility	TC	$28.55	$67.09	$85.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.95 / $42.54 / $80.95	Professional		$37.95	$42.54	$80.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.65 / $14.44 / $27.14	Professional	26	$12.65	$14.44	$27.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $28.55 / $53.64	Professional	TC	$23.51	$28.55	$53.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $35.79 / $43.38	Professional		$35.79	$35.79	$43.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.12 / $11.32 / $24.33	Professional	26	$11.12	$11.32	$24.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $47.79 / $79.48	Professional		$38.97	$47.79	$79.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.23 / $17.95 / $31.67	Professional	26	$15.23	$17.95	$31.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.63 / $29.39 / $48.51	Professional	TC	$23.63	$29.39	$48.51
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $48.78 / $48.78 / $48.78	Professional		$48.78	$48.78	$48.78
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $16.39 / $16.39	Professional	26	$16.39	$16.39	$16.39
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $32.38 / $32.38 / $32.38	Professional	TC	$32.38	$32.38	$32.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.29 / $30.18 / $45.47	Professional		$15.29	$30.18	$45.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $19.09	Facility	26	$16.60	$16.60	$19.09
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.06 / $35.04 / $35.04	Facility	TC	$29.06	$35.04	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.53 / $55.28 / $96.04	Professional		$37.53	$55.28	$96.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.81 / $19.80 / $33.86	Professional	26	$12.81	$19.80	$33.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.35 / $34.31 / $64.63	Professional	TC	$24.35	$34.31	$64.63
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $19.09	Facility	26	$16.60	$16.60	$19.09
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $29.06 / $29.06 / $35.04	Facility	TC	$29.06	$29.06	$35.04
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $40.19 / $55.16 / $92.61	Professional		$40.19	$55.16	$92.61
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $13.90 / $20.14 / $33.86	Professional	26	$13.90	$20.14	$33.86
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $25.14 / $35.06 / $61.48	Professional	TC	$25.14	$35.06	$61.48
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 $36.81 / $49.16 / $84.22	Professional		$36.81	$49.16	$84.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.28 / $18.61 / $32.29	Professional	26	$13.28	$18.61	$32.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.23 / $30.17 / $53.80	Professional	TC	$22.23	$30.17	$53.80