Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.33 / $22.05 / $48.48	Facility	26	$13.33	$22.05	$48.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.27 / $42.28 / $77.72	Professional		$36.27	$42.28	$77.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $13.64 / $37.09	Professional	26	$11.50	$13.64	$37.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.23 / $28.75 / $54.45	Professional	TC	$24.23	$28.75	$54.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.19 / $34.47 / $41.47	Professional		$25.19	$34.47	$41.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.25 / $15.38 / $21.47	Professional	26	$10.25	$15.38	$21.47
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.35 / $26.35 / $26.35	Professional	TC	$26.35	$26.35	$26.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $45.61 / $77.62	Professional		$36.10	$45.61	$77.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.70 / $16.20 / $28.02	Professional	26	$13.70	$16.20	$28.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.40 / $29.31 / $49.62	Professional	TC	$22.40	$29.31	$49.62
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $46.63 / $46.63 / $51.38	Professional		$46.63	$46.63	$51.38
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $15.29 / $15.29 / $16.85	Professional	26	$15.29	$15.29	$16.85
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $31.34 / $31.34 / $34.53	Professional	TC	$31.34	$31.34	$34.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.26 / $29.22 / $43.47	Professional		$14.26	$29.22	$43.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.80 / $15.80 / $17.44	Facility	26	$15.80	$15.80	$17.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.46 / $53.38 / $93.76	Professional		$35.46	$53.38	$93.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.80 / $18.00 / $29.71	Professional	26	$11.80	$18.00	$29.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.01 / $35.75 / $60.06	Professional	TC	$24.01	$35.75	$60.06
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $15.80 / $15.80 / $17.44	Facility	26	$15.80	$15.80	$17.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $53.66 / $88.52	Professional		$35.22	$53.66	$88.52
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $18.22 / $32.18	Professional	26	$12.96	$18.22	$32.18
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $35.75 / $59.29	Professional	TC	$24.83	$35.75	$59.29
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 $34.82 / $47.16 / $81.65	Professional		$34.82	$47.16	$81.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.87 / $16.45 / $28.97	Professional	26	$11.87	$16.45	$28.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.73 / $29.56 / $54.17	Professional	TC	$22.73	$29.56	$54.17