Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.16 / $10.24 / $26.50	Facility	26	$7.16	$10.24	$26.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $13.08 / $39.24 / $338.40	Facility	TC	$13.08	$39.24	$338.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.72 / $23.58 / $42.40	Professional		$17.72	$23.58	$42.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $8.13 / $23.10	Professional	26	$6.42	$8.13	$23.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.13 / $16.00 / $27.73	Professional	TC	$12.13	$16.00	$27.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.43 / $17.19 / $20.54	Professional		$15.43	$17.19	$20.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.56 / $9.03 / $12.80	Professional	26	$5.56	$9.03	$12.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.50 / $25.36 / $44.02	Professional		$20.50	$25.36	$44.02
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.70 / $9.02 / $15.83	Professional	26	$7.70	$9.02	$15.83
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $30.75 / $38.27 / $66.15	Professional	50	$30.75	$38.27	$66.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.80 / $16.35 / $28.37	Professional	TC	$12.80	$16.35	$28.37
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $23.20 / $23.20 / $23.20	Professional		$23.20	$23.20	$23.20
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.19 / $8.19 / $8.19	Professional	26	$8.19	$8.19	$8.19
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $15.00 / $15.00	Professional	TC	$15.00	$15.00	$15.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.65 / $16.14 / $27.52	Professional		$7.65	$16.14	$27.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $9.44	Facility	26	$8.46	$8.46	$9.44
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $16.98	Facility	TC	$16.03	$16.03	$16.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $28.54 / $50.05	Professional		$18.73	$28.54	$50.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $9.80 / $16.54	Professional	26	$6.47	$9.80	$16.54
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.05 / $31.05 / $31.05	Professional	50	$31.05	$31.05	$31.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.97 / $19.14 / $31.33	Professional	TC	$11.97	$19.14	$31.33
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $9.44	Facility	26	$8.46	$8.46	$9.44
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $190.42 / $364.15	Facility	TC	$16.03	$190.42	$364.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $19.27 / $27.53 / $46.61	Professional		$19.27	$27.53	$46.61
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $10.10 / $20.77	Professional	26	$7.03	$10.10	$20.77
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $12.38 / $18.43 / $31.26	Professional	TC	$12.38	$18.43	$31.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.10 / $7.18 / $20.51	Professional		$6.10	$7.18	$20.51
United Facility/Professional Professional Modifier Low / Median / High Price $18.36 / $24.44 / $42.55	Professional		$18.36	$24.44	$42.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.78 / $15.20	Professional	26	$6.46	$8.78	$15.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.67 / $15.32 / $26.49	Professional	TC	$11.67	$15.32	$26.49