Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.64 / $19.51 / $49.66	Facility	26	$13.64	$19.51	$49.66
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $47.72 / $309.26 / $559.63	Facility	TC	$47.72	$309.26	$559.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $53.66 / $106.15	Professional		$44.27	$53.66	$106.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.68 / $15.43 / $33.38	Professional	26	$12.68	$15.43	$33.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.84 / $29.84 / $29.84	Professional	50	$29.84	$29.84	$29.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $36.45 / $71.76	Professional	TC	$30.85	$36.45	$71.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.02 / $48.74 / $75.41	Professional		$40.02	$48.74	$75.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.49 / $13.78 / $21.96	Professional	26	$10.49	$13.78	$21.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.34 / $29.34 / $29.34	Professional	TC	$29.34	$29.34	$29.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.37 / $55.64 / $91.98	Professional		$45.37	$55.64	$91.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.71 / $17.30 / $30.03	Professional	26	$14.71	$17.30	$30.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $68.05 / $83.04 / $140.16	Professional	50	$68.05	$83.04	$140.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.94 / $38.58 / $63.07	Professional	TC	$30.94	$38.58	$63.07
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $57.41 / $63.25 / $63.25	Professional		$57.41	$63.25	$63.25
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $15.64 / $17.23 / $17.23	Professional	26	$15.64	$17.23	$17.23
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $41.77 / $46.02 / $46.02	Professional	TC	$41.77	$46.02	$46.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.58 / $44.56 / $68.11	Professional		$14.58	$44.56	$68.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $16.14 / $17.67	Facility	26	$16.14	$16.14	$17.67
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $44.74 / $44.74	Facility	TC	$38.02	$44.74	$44.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.87 / $64.03 / $111.90	Professional		$43.87	$64.03	$111.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $18.93 / $31.96	Professional	26	$12.39	$18.93	$31.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.47 / $44.69 / $82.51	Professional	TC	$31.47	$44.69	$82.51
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $16.14 / $17.67	Facility	26	$16.14	$16.14	$17.67
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $38.02 / $44.74	Facility	TC	$38.02	$38.02	$44.74
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $46.22 / $64.03 / $104.96	Professional		$46.22	$64.03	$104.96
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $13.41 / $19.47 / $37.70	Professional	26	$13.41	$19.47	$37.70
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $32.67 / $45.37 / $74.34	Professional	TC	$32.67	$45.37	$74.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.98 / $36.24 / $51.07	Professional		$26.98	$36.24	$51.07
United Facility/Professional Professional Modifier Low / Median / High Price $39.59 / $54.15 / $99.77	Professional		$39.59	$54.15	$99.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $17.43 / $30.16	Professional	26	$12.29	$17.43	$30.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.77 / $39.20 / $71.15	Professional	TC	$29.77	$39.20	$71.15