Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.67 / $23.04 / $46.22	Facility	26	$12.67	$23.04	$46.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $55.47 / $109.27	Professional		$46.93	$55.47	$109.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.43 / $13.40 / $25.41	Professional	26	$11.43	$13.40	$25.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $42.80 / $82.01	Professional	TC	$34.14	$42.80	$82.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.61 / $50.61 / $57.50	Professional		$50.61	$50.61	$57.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $17.70 / $22.12	Professional	26	$9.86	$17.70	$22.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.35 / $60.12 / $98.99	Professional		$48.35	$60.12	$98.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.90 / $16.43 / $28.59	Professional	26	$13.90	$16.43	$28.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.05 / $88.86 / $148.49	Professional	50	$72.05	$88.86	$148.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.22 / $43.91 / $70.53	Professional	TC	$34.22	$43.91	$70.53
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $64.34 / $64.34 / $64.34	Professional		$64.34	$64.34	$64.34
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $14.92 / $14.92	Professional	26	$14.92	$14.92	$14.92
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $49.42 / $49.42 / $49.42	Professional	TC	$49.42	$49.42	$49.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.90 / $52.74 / $76.34	Professional		$13.90	$52.74	$76.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $16.42	Facility	26	$15.00	$15.00	$16.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.77 / $69.02 / $124.49	Professional		$47.77	$69.02	$124.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.50 / $17.79 / $30.16	Professional	26	$11.50	$17.79	$30.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.60 / $51.10 / $93.82	Professional	TC	$35.60	$51.10	$93.82
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $16.42	Facility	26	$15.00	$15.00	$16.42
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $50.13 / $68.89 / $114.51	Professional		$50.13	$68.89	$114.51
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $12.64 / $18.80 / $30.51	Professional	26	$12.64	$18.80	$30.51
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $37.06 / $51.93 / $87.96	Professional	TC	$37.06	$51.93	$87.96
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 $44.57 / $61.21 / $107.65	Professional		$44.57	$61.21	$107.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $15.69 / $27.44	Professional	26	$11.72	$15.69	$27.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.92 / $43.30 / $77.80	Professional	TC	$32.92	$43.30	$77.80