Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.49 / $11.03 / $211.01	Facility	26	$6.49	$11.03	$211.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.24 / $232.18 / $552.72	Facility	TC	$39.24	$232.18	$552.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.76 / $35.86 / $77.84	Professional		$13.76	$35.86	$77.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.51 / $23.94	Professional	26	$6.03	$9.51	$23.94
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.77 / $21.77 / $21.77	Professional	50	$21.77	$21.77	$21.77
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.51 / $17.67 / $30.53	Professional	52	$12.51	$17.67	$30.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $31.94 / $59.94	Professional	TC	$22.57	$31.94	$59.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.81 / $29.77 / $60.00	Professional		$24.81	$29.77	$60.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.05 / $7.65 / $11.04	Professional	26	$5.05	$7.65	$11.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $33.54 / $44.83	Professional	TC	$23.23	$33.54	$44.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.59 / $29.45 / $50.13	Professional		$22.59	$29.45	$50.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.14 / $8.19 / $14.73	Professional	26	$6.14	$8.19	$14.73
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $33.88 / $43.47 / $75.20	Professional	50	$33.88	$43.47	$75.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $20.53 / $38.70	Professional	TC	$15.59	$20.53	$38.70
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $40.52 / $44.64 / $44.99	Professional		$40.52	$44.64	$44.99
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $8.19 / $8.27	Professional	26	$7.45	$8.19	$8.27
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $33.08 / $36.44 / $36.72	Professional	TC	$33.08	$36.44	$36.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.94 / $33.83 / $49.43	Professional		$6.94	$33.83	$49.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $8.19	Facility	26	$7.66	$7.66	$8.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.06 / $35.40 / $35.40	Facility	TC	$29.06	$35.40	$35.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.24 / $41.90 / $77.01	Professional		$27.24	$41.90	$77.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.71 / $8.83 / $15.11	Professional	26	$5.71	$8.83	$15.11
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.71 / $43.71 / $43.71	Professional	50	$43.71	$43.71	$43.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.26 / $32.69 / $62.80	Professional	TC	$21.26	$32.69	$62.80
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $8.19	Facility	26	$7.66	$7.66	$8.19
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $29.06 / $162.19 / $556.44	Facility	TC	$29.06	$162.19	$556.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $25.94 / $41.47 / $76.92	Professional		$25.94	$41.47	$76.92
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $6.38 / $9.94 / $18.82	Professional	26	$6.38	$9.94	$18.82
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $22.81 / $34.14 / $61.07	Professional	TC	$22.81	$34.14	$61.07
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 $23.46 / $36.82 / $68.56	Professional		$23.46	$36.82	$68.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.87 / $8.00 / $13.72	Professional	26	$5.87	$8.00	$13.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.96 / $29.62 / $52.79	Professional	TC	$17.96	$29.62	$52.79