Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.49 / $10.71 / $26.60	Facility	26	$7.49	$10.71	$26.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.04 / $30.00 / $77.47	Professional		$21.04	$30.00	$77.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $9.83 / $26.60	Professional	26	$6.94	$9.83	$26.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $14.06 / $14.06 / $114.00	Professional	50	$14.06	$14.06	$114.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.52 / $13.32 / $23.71	Professional	52	$10.52	$13.32	$23.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.18 / $21.27 / $40.60	Professional	TC	$17.18	$21.27	$40.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.01 / $29.43 / $46.65	Professional		$21.01	$29.43	$46.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $7.62 / $13.39	Professional	26	$5.82	$7.62	$13.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.84 / $28.38 / $28.38	Professional	TC	$21.84	$28.38	$28.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.35 / $29.56 / $50.74	Professional		$24.35	$29.56	$50.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.59 / $17.55	Professional	26	$8.13	$9.59	$17.55
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $36.52 / $44.70 / $76.59	Professional	50	$36.52	$44.70	$76.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.95 / $19.88 / $33.35	Professional	TC	$15.95	$19.88	$33.35
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $33.27	Professional		$30.20	$30.20	$33.27
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $8.59 / $9.46	Professional	26	$8.59	$8.59	$9.46
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $21.61 / $21.61 / $23.80	Professional	TC	$21.61	$21.61	$23.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.01 / $22.94 / $35.83	Professional		$8.01	$22.94	$35.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $9.48	Facility	26	$8.86	$8.86	$9.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.01 / $35.31 / $62.25	Professional		$24.01	$35.31	$62.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.77 / $10.27 / $17.25	Professional	26	$6.77	$10.27	$17.25
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.13 / $35.13 / $35.13	Professional	50	$35.13	$35.13	$35.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.78 / $24.89 / $44.66	Professional	TC	$16.78	$24.89	$44.66
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $9.48	Facility	26	$8.86	$8.86	$9.48
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $24.05 / $34.61 / $59.80	Professional		$24.05	$34.61	$59.80
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $10.57 / $19.38	Professional	26	$7.36	$10.57	$19.38
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $17.61 / $24.90 / $42.11	Professional	TC	$17.61	$24.90	$42.11
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 $22.34 / $30.47 / $53.18	Professional		$22.34	$30.47	$53.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $9.19 / $16.16	Professional	26	$6.49	$9.19	$16.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $21.18 / $38.40	Professional	TC	$15.49	$21.18	$38.40