Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.54 / $27.37 / $60.02	Facility	26	$16.54	$27.37	$60.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $73.29 / $144.38	Professional		$61.64	$73.29	$144.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.67 / $16.54 / $30.74	Professional	26	$14.67	$16.54	$30.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $56.75 / $109.00	Professional	TC	$46.00	$56.75	$109.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.33 / $59.33 / $59.33	Professional		$59.33	$59.33	$59.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $19.30 / $22.51	Professional	26	$12.86	$19.30	$22.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.60 / $79.03 / $129.65	Professional		$63.60	$79.03	$129.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $20.47 / $34.97	Professional	26	$17.17	$20.47	$34.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.07 / $59.10 / $94.92	Professional	TC	$46.07	$59.10	$94.92
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $131.49 / $131.49 / $131.49	Professional		$131.49	$131.49	$131.49
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $29.43 / $29.43 / $29.43	Professional	26	$29.43	$29.43	$29.43
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $102.06 / $102.06 / $102.06	Professional	TC	$102.06	$102.06	$102.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.69 / $61.35 / $79.04	Professional		$17.69	$61.35	$79.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $21.44	Facility	26	$19.60	$19.60	$21.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.66 / $91.21 / $165.25	Professional		$63.66	$91.21	$165.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.05 / $22.86 / $37.57	Professional	26	$15.05	$22.86	$37.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.05 / $68.97 / $128.10	Professional	TC	$49.05	$68.97	$128.10
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $21.44	Facility	26	$19.60	$19.60	$21.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $68.26 / $92.23 / $150.88	Professional		$68.26	$92.23	$150.88
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $16.29 / $23.25 / $41.74	Professional	26	$16.29	$23.25	$41.74
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $51.32 / $69.72 / $117.12	Professional	TC	$51.32	$69.72	$117.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $53.04 / $72.49 / $102.15	Professional		$53.04	$72.49	$102.15
United Facility/Professional Professional Modifier Low / Median / High Price $60.30 / $82.40 / $147.97	Professional		$60.30	$82.40	$147.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.27 / $21.20 / $35.88	Professional	26	$15.27	$21.20	$35.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.72 / $62.00 / $111.40	Professional	TC	$39.72	$62.00	$111.40