Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $17.67 / $45.13	Facility	26	$12.36	$17.67	$45.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.64 / $73.14 / $391.04	Facility	TC	$27.64	$73.14	$391.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $40.00 / $84.80	Professional		$35.22	$40.00	$84.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.35 / $13.26 / $28.30	Professional	26	$11.35	$13.26	$28.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $27.64 / $51.90	Professional	TC	$23.17	$27.64	$51.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.51 / $43.20 / $70.31	Professional		$40.51	$43.20	$70.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $11.18 / $81.90	Professional	26	$9.61	$11.18	$81.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.70 / $44.54 / $74.06	Professional		$35.70	$44.54	$74.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $15.28 / $27.23	Professional	26	$13.00	$15.28	$27.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.47 / $28.68 / $47.84	Professional	TC	$22.47	$28.68	$47.84
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $45.51 / $45.51 / $45.51	Professional		$45.51	$45.51	$45.51
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $14.17 / $14.17 / $14.17	Professional	26	$14.17	$14.17	$14.17
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $31.34 / $31.34 / $31.34	Professional	TC	$31.34	$31.34	$31.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.21 / $29.22 / $42.43	Professional		$13.21	$29.22	$42.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $16.03	Facility	26	$14.65	$14.65	$16.03
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $28.67 / $33.92 / $33.92	Facility	TC	$28.67	$33.92	$33.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.08 / $51.52 / $89.16	Professional		$35.08	$51.52	$89.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.94 / $17.05 / $29.07	Professional	26	$10.94	$17.05	$29.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.87 / $33.83 / $62.91	Professional	TC	$23.87	$33.83	$62.91
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $16.03	Facility	26	$14.65	$14.65	$16.03
Medical Mutual of Ohio Facility/Professional Facility Modifier TC Low / Median / High Price $28.67 / $28.67 / $33.92	Facility	TC	$28.67	$28.67	$33.92
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $51.47 / $88.72	Professional		$36.65	$51.47	$88.72
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $17.92 / $33.64	Professional	26	$12.17	$17.92	$33.64
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $34.32 / $59.50	Professional	TC	$24.83	$34.32	$59.50
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 $34.00 / $45.89 / $78.89	Professional		$34.00	$45.89	$78.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $15.18 / $26.93	Professional	26	$11.01	$15.18	$26.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $30.37 / $54.17	Professional	TC	$22.74	$30.37	$54.17