Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $17.30 / $52.02	Facility	26	$12.36	$17.30	$52.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.39 / $60.63 / $131.83	Professional		$47.39	$60.63	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.35 / $17.61 / $46.18	Professional	26	$12.35	$17.61	$46.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.61 / $42.47 / $77.58	Professional	TC	$33.61	$42.47	$77.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $41.41 / $48.71	Professional		$31.42	$41.41	$48.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.85 / $15.76 / $20.39	Professional	26	$9.85	$15.76	$20.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.90 / $37.01 / $56.23	Professional	TC	$34.90	$37.01	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.06 / $54.50 / $95.03	Professional		$40.06	$54.50	$95.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $17.97 / $31.94	Professional	26	$14.93	$17.97	$31.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.68 / $36.54 / $62.46	Professional	TC	$24.68	$36.54	$62.46
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $57.34 / $57.34 / $57.34	Professional		$57.34	$57.34	$57.34
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $14.53 / $14.53 / $14.53	Professional	26	$14.53	$14.53	$14.53
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $42.81 / $42.81 / $42.81	Professional	TC	$42.81	$42.81	$42.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.54 / $45.68 / $68.03	Professional		$13.54	$45.68	$68.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $18.54	Facility	26	$14.65	$14.65	$18.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.27 / $64.76 / $114.08	Professional		$43.27	$64.76	$114.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $17.86 / $30.46	Professional	26	$12.17	$17.86	$30.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.52 / $47.04 / $81.28	Professional	TC	$31.52	$47.04	$81.28
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $18.54	Facility	26	$14.65	$14.65	$18.54
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $42.23 / $64.62 / $117.02	Professional		$42.23	$64.62	$117.02
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $12.92 / $21.59 / $41.18	Professional	26	$12.92	$21.59	$41.18
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $47.18 / $79.64	Professional	TC	$32.36	$47.18	$79.64
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 $41.98 / $55.47 / $97.38	Professional		$41.98	$55.47	$97.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $16.30 / $30.95	Professional	26	$12.17	$16.30	$30.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.74 / $39.58 / $70.64	Professional	TC	$27.74	$39.58	$70.64