Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.79 / $11.14 / $28.77	Facility	26	$7.79	$11.14	$28.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $38.15 / $70.09	Professional		$30.51	$38.15	$70.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.28 / $8.90 / $16.92	Professional	26	$7.28	$8.90	$16.92
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $13.09 / $13.09 / $13.09	Professional	50	$13.09	$13.09	$13.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $29.15 / $55.29	Professional	TC	$22.26	$29.15	$55.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.48 / $31.40 / $66.06	Professional		$27.48	$31.40	$66.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.18 / $13.04	Professional	26	$6.17	$8.18	$13.04
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $43.45 / $43.45 / $43.45	Professional	TC	$43.45	$43.45	$43.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.68 / $33.47 / $57.44	Professional		$25.68	$33.47	$57.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.67 / $10.43 / $19.29	Professional	26	$8.67	$10.43	$19.29
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.52 / $50.57 / $86.16	Professional	50	$38.52	$50.57	$86.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $21.97 / $42.04	Professional	TC	$16.89	$21.97	$42.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.66 / $34.70 / $50.62	Professional		$8.66	$34.70	$50.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $10.26	Facility	26	$9.30	$9.30	$10.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.75 / $45.22 / $84.02	Professional		$30.75	$45.22	$84.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $11.25 / $19.05	Professional	26	$7.65	$11.25	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $34.20 / $66.18	Professional	TC	$21.78	$34.20	$66.18
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $10.26	Facility	26	$9.30	$9.30	$10.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $30.75 / $44.88 / $78.37	Professional		$30.75	$44.88	$78.37
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.80 / $11.32 / $18.92	Professional	26	$7.80	$11.32	$18.92
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $23.48 / $34.35 / $58.87	Professional	TC	$23.48	$34.35	$58.87
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 $25.37 / $40.03 / $72.79	Professional		$25.37	$40.03	$72.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.32 / $10.29 / $18.98	Professional	26	$7.32	$10.29	$18.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.38 / $30.98 / $59.13	Professional	TC	$19.38	$30.98	$59.13