Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $20.50 / $53.10	Facility	26	$14.65	$20.50	$53.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $59.90 / $116.94	Professional		$50.72	$59.90	$116.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $16.52 / $31.06	Professional	26	$13.49	$16.52	$31.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $42.80 / $82.17	Professional	TC	$37.11	$42.80	$82.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.66 / $48.65 / $64.19	Professional		$44.66	$48.65	$64.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $17.59 / $24.17	Professional	26	$11.39	$17.59	$24.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.01 / $64.45 / $64.45	Professional	TC	$40.01	$64.45	$64.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.54 / $64.48 / $106.34	Professional		$52.54	$64.48	$106.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.74 / $18.48 / $32.10	Professional	26	$15.74	$18.48	$32.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.19 / $46.18 / $75.81	Professional	TC	$37.19	$46.18	$75.81
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.65 / $52.39 / $78.15	Professional		$15.65	$52.39	$78.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $18.93	Facility	26	$17.32	$17.32	$18.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.56 / $74.22 / $128.72	Professional		$50.56	$74.22	$128.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $20.16 / $34.15	Professional	26	$13.23	$20.16	$34.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $53.65 / $97.42	Professional	TC	$36.97	$53.65	$97.42
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $18.93	Facility	26	$17.32	$17.32	$18.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $53.07 / $74.61 / $131.94	Professional		$53.07	$74.61	$131.94
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $14.43 / $21.60 / $41.16	Professional	26	$14.43	$21.60	$41.16
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $38.00 / $53.75 / $87.34	Professional	TC	$38.00	$53.75	$87.34
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 $48.88 / $67.03 / $113.16	Professional		$48.88	$67.03	$113.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.20 / $17.98 / $31.68	Professional	26	$13.20	$17.98	$31.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.92 / $46.10 / $81.58	Professional	TC	$31.92	$46.10	$81.58