Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.68 / $20.38 / $53.20	Facility	26	$14.68	$20.38	$53.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.50 / $49.76 / $98.35	Professional		$41.50	$49.76	$98.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $20.34 / $45.66	Professional	26	$13.58	$20.34	$45.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.37 / $34.22 / $64.18	Professional	TC	$28.37	$34.22	$64.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.13 / $37.39 / $93.29	Professional		$37.13	$37.39	$93.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.64 / $15.24 / $26.78	Professional	26	$11.64	$15.24	$26.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $29.51 / $29.51	Professional	TC	$29.51	$29.51	$29.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.02 / $49.26 / $84.82	Professional		$35.02	$49.26	$84.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $18.89 / $33.06	Professional	26	$15.73	$18.89	$33.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.29 / $29.15 / $51.53	Professional	TC	$19.29	$29.15	$51.53
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $53.38 / $53.38 / $53.38	Professional		$53.38	$53.38	$53.38
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $17.18 / $17.18 / $17.18	Professional	26	$17.18	$17.18	$17.18
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $36.21 / $36.21 / $36.21	Professional	TC	$36.21	$36.21	$36.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.02 / $38.60 / $63.34	Professional		$16.02	$38.60	$63.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $18.97	Facility	26	$17.36	$17.36	$18.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.07 / $60.72 / $106.52	Professional		$41.07	$60.72	$106.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.24 / $20.44 / $34.15	Professional	26	$13.24	$20.44	$34.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $40.89 / $71.17	Professional	TC	$27.54	$40.89	$71.17
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $18.97	Facility	26	$17.36	$17.36	$18.97
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $41.57 / $60.72 / $107.94	Professional		$41.57	$60.72	$107.94
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $21.35 / $42.59	Professional	26	$14.45	$21.35	$42.59
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $28.59 / $41.45 / $69.19	Professional	TC	$28.59	$41.45	$69.19
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 $40.65 / $53.44 / $92.37	Professional		$40.65	$53.44	$92.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $18.12 / $31.08	Professional	26	$13.03	$18.12	$31.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.66 / $34.04 / $60.03	Professional	TC	$25.66	$34.04	$60.03