Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.42 / $14.91 / $38.15	Facility	26	$10.42	$14.91	$38.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.22 / $309.70 / $452.14	Facility	TC	$32.22	$309.70	$452.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $35.56 / $76.12	Professional		$30.19	$35.56	$76.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.26 / $14.81 / $30.07	Professional	26	$10.26	$14.81	$30.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $24.00 / $49.63	Professional	TC	$19.89	$24.00	$49.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.63 / $27.63 / $35.11	Professional		$21.63	$27.63	$35.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $10.93 / $18.25	Professional	26	$8.22	$10.93	$18.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.14 / $35.68 / $35.68	Professional	TC	$22.14	$35.68	$35.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $38.04 / $64.62	Professional		$30.51	$38.04	$64.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $12.91 / $23.00	Professional	26	$11.14	$12.91	$23.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $24.72 / $41.11	Professional	TC	$19.30	$24.72	$41.11
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $39.47 / $43.49 / $43.49	Professional		$39.47	$43.49	$43.49
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $12.31 / $13.56 / $13.56	Professional	26	$12.31	$13.56	$13.56
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $27.16 / $29.93 / $29.93	Professional	TC	$27.16	$29.93	$29.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.47 / $28.90 / $46.83	Professional		$11.47	$28.90	$46.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $13.68	Facility	26	$12.36	$12.36	$13.68
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.17 / $29.08 / $29.08	Facility	TC	$25.17	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.03 / $44.03 / $76.94	Professional		$30.03	$44.03	$76.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $14.76 / $25.02	Professional	26	$9.36	$14.76	$25.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.46 / $29.11 / $54.32	Professional	TC	$20.46	$29.11	$54.32
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $13.68	Facility	26	$12.36	$12.36	$13.68
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $25.17 / $176.80 / $383.35	Facility	TC	$25.17	$176.80	$383.35
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $44.03 / $85.37	Professional		$30.91	$44.03	$85.37
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.54 / $15.45 / $30.15	Professional	26	$10.54	$15.45	$30.15
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $29.73 / $51.57	Professional	TC	$21.10	$29.73	$51.57
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 $29.03 / $39.36 / $69.26	Professional		$29.03	$39.36	$69.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.64 / $13.50 / $23.16	Professional	26	$9.64	$13.50	$23.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.41 / $24.96 / $44.87	Professional	TC	$18.41	$24.96	$44.87