Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.01 / $19.61 / $54.28	Facility	26	$14.01	$19.61	$54.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.93 / $70.19 / $120.44	Professional		$51.93	$70.19	$120.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.98 / $18.77 / $54.28	Professional	26	$12.98	$18.77	$54.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.75 / $51.21 / $90.74	Professional	TC	$38.75	$51.21	$90.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $48.13 / $58.15	Professional		$39.93	$48.13	$58.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.32 / $23.05	Professional	26	$10.96	$16.32	$23.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.79 / $68.27 / $118.48	Professional		$50.79	$68.27	$118.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $20.30 / $37.36	Professional	26	$16.98	$20.30	$37.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.95 / $46.78 / $80.51	Professional	TC	$32.95	$46.78	$80.51
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $65.14 / $65.14 / $65.14	Professional		$65.14	$65.14	$65.14
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $16.41 / $16.41	Professional	26	$16.41	$16.41	$16.41
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $48.72 / $48.72 / $48.72	Professional	TC	$48.72	$48.72	$48.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.30 / $52.01 / $77.28	Professional		$15.30	$52.01	$77.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $19.36	Facility	26	$16.57	$16.57	$19.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.83 / $80.48 / $140.61	Professional		$52.83	$80.48	$140.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.63 / $20.39 / $34.25	Professional	26	$13.63	$20.39	$34.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.21 / $58.77 / $101.07	Professional	TC	$38.21	$58.77	$101.07
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $19.36	Facility	26	$16.57	$16.57	$19.36
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $53.36 / $80.48 / $133.29	Professional		$53.36	$80.48	$133.29
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $13.81 / $20.95 / $42.03	Professional	26	$13.81	$20.95	$42.03
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $39.22 / $58.74 / $100.68	Professional	TC	$39.22	$58.74	$100.68
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 $49.22 / $67.39 / $117.36	Professional		$49.22	$67.39	$117.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.45 / $17.87 / $30.25	Professional	26	$12.45	$17.87	$30.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.19 / $49.19 / $85.02	Professional	TC	$37.19	$49.19	$85.02