Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.03 / $17.20 / $45.03	Facility	26	$12.03	$17.20	$45.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $40.69 / $76.64	Professional		$35.09	$40.69	$76.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.17 / $15.75 / $33.04	Professional	26	$11.17	$15.75	$33.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $27.64 / $53.89	Professional	TC	$23.26	$27.64	$53.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $31.07 / $40.82	Professional		$29.51	$31.07	$40.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $9.94 / $19.38	Professional	26	$9.35	$9.94	$19.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.93 / $26.93 / $26.93	Professional	TC	$26.93	$26.93	$26.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $44.39 / $73.38	Professional		$34.82	$44.39	$73.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.10 / $15.17 / $26.58	Professional	26	$12.10	$15.17	$26.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.38 / $29.32 / $47.66	Professional	TC	$23.38	$29.32	$47.66
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $45.83 / $50.49 / $50.88	Professional		$45.83	$50.49	$50.88
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $13.79 / $15.20 / $15.31	Professional	26	$13.79	$15.20	$15.31
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $32.04 / $35.29 / $35.57	Professional	TC	$32.04	$35.29	$35.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.86 / $34.13 / $54.38	Professional		$12.86	$34.13	$54.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $15.99	Facility	26	$14.26	$14.26	$15.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.92 / $51.14 / $88.59	Professional		$34.92	$51.14	$88.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.91 / $16.66 / $28.19	Professional	26	$10.91	$16.66	$28.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.87 / $33.94 / $62.91	Professional	TC	$23.87	$33.94	$62.91
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $15.99	Facility	26	$14.26	$14.26	$15.99
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $36.90 / $50.97 / $83.83	Professional		$36.90	$50.97	$83.83
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $17.54 / $29.02	Professional	26	$11.88	$17.54	$29.02
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $34.10 / $57.01	Professional	TC	$24.83	$34.10	$57.01
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 $31.59 / $43.48 / $78.83	Professional		$31.59	$43.48	$78.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.98 / $15.08 / $26.68	Professional	26	$10.98	$15.08	$26.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.51 / $29.80 / $52.13	Professional	TC	$22.51	$29.80	$52.13