Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.98 / $26.63 / $562.12	Facility	26	$14.98	$26.63	$562.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.39 / $53.00 / $96.49	Professional		$43.39	$53.00	$96.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $15.82 / $44.12	Professional	26	$13.58	$15.82	$44.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.56 / $37.68 / $69.54	Professional	TC	$30.56	$37.68	$69.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.10 / $40.21 / $49.66	Professional		$39.10	$40.21	$49.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.64 / $14.65 / $24.72	Professional	26	$11.64	$14.65	$24.72
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $50.76 / $50.76 / $50.76	Professional	TC	$50.76	$50.76	$50.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $54.28 / $92.23	Professional		$40.40	$54.28	$92.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $18.89 / $33.06	Professional	26	$15.73	$18.89	$33.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.68 / $35.04 / $59.65	Professional	TC	$24.68	$35.04	$59.65
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $55.81 / $55.81 / $55.81	Professional		$55.81	$55.81	$55.81
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $17.18 / $17.18 / $17.18	Professional	26	$17.18	$17.18	$17.18
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $38.65 / $38.65 / $38.65	Professional	TC	$38.65	$38.65	$38.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.02 / $36.03 / $52.03	Professional		$16.02	$36.03	$52.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.71 / $17.71 / $19.36	Facility	26	$17.71	$17.71	$19.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $65.28 / $113.60	Professional		$44.45	$65.28	$113.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.53 / $20.38 / $34.15	Professional	26	$13.53	$20.38	$34.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.84 / $45.19 / $78.94	Professional	TC	$29.84	$45.19	$78.94
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $17.71 / $17.71 / $19.36	Facility	26	$17.71	$17.71	$19.36
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $44.54 / $64.64 / $110.61	Professional		$44.54	$64.64	$110.61
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $14.73 / $21.05 / $38.38	Professional	26	$14.73	$21.05	$38.38
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $30.79 / $45.84 / $75.55	Professional	TC	$30.79	$45.84	$75.55
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 $43.61 / $56.76 / $97.29	Professional		$43.61	$56.76	$97.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.32 / $18.48 / $32.39	Professional	26	$13.32	$18.48	$32.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.53 / $37.28 / $66.41	Professional	TC	$26.53	$37.28	$66.41