Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.01 / $20.03 / $60.12	Facility	26	$14.01	$20.03	$60.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.53 / $67.65 / $123.00	Professional		$53.53	$67.65	$123.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.78 / $18.91 / $55.90	Professional	26	$13.78	$18.91	$55.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.02 / $50.61 / $86.69	Professional	TC	$39.02	$50.61	$86.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.36 / $48.64 / $58.79	Professional		$40.36	$48.64	$58.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $16.45 / $25.05	Professional	26	$10.89	$16.45	$25.05
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.97 / $41.84 / $56.33	Professional	TC	$34.97	$41.84	$56.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.55 / $67.53 / $113.61	Professional		$51.55	$67.53	$113.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.73 / $20.42 / $37.79	Professional	26	$16.73	$20.42	$37.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.29 / $45.55 / $75.92	Professional	TC	$33.29	$45.55	$75.92
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $65.83 / $65.83 / $65.83	Professional		$65.83	$65.83	$65.83
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $16.05 / $16.05 / $16.05	Professional	26	$16.05	$16.05	$16.05
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $49.77 / $49.77 / $49.77	Professional	TC	$49.77	$49.77	$49.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.97 / $53.14 / $78.11	Professional		$14.97	$53.14	$78.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $21.48	Facility	26	$16.57	$16.57	$21.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.67 / $78.06 / $137.03	Professional		$51.67	$78.06	$137.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.61 / $20.42 / $34.68	Professional	26	$13.61	$20.42	$34.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.03 / $57.22 / $100.18	Professional	TC	$38.03	$57.22	$100.18
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $21.48	Facility	26	$16.57	$16.57	$21.48
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $51.86 / $77.02 / $133.29	Professional		$51.86	$77.02	$133.29
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $14.29 / $22.10 / $39.53	Professional	26	$14.29	$22.10	$39.53
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $38.95 / $57.96 / $94.93	Professional	TC	$38.95	$57.96	$94.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.78 / $53.04 / $92.69	Professional		$29.78	$53.04	$92.69
United Facility/Professional Professional Modifier Low / Median / High Price $49.83 / $67.39 / $115.52	Professional		$49.83	$67.39	$115.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.31 / $18.32 / $32.06	Professional	26	$13.31	$18.32	$32.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.34 / $48.27 / $84.00	Professional	TC	$34.34	$48.27	$84.00