Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.35 / $21.43 / $50.94	Facility	26	$14.35	$21.43	$50.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $57.01 / $147.53	Professional		$37.50	$57.01	$147.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $14.35 / $32.56	Professional	26	$7.33	$14.35	$32.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.85 / $32.54 / $96.56	Professional	TC	$24.85	$32.54	$96.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.00 / $11.39 / $11.82	Professional	26	$11.00	$11.39	$11.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.80 / $63.13 / $119.01	Professional		$47.80	$63.13	$119.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $11.53 / $21.02	Professional	26	$8.11	$11.53	$21.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.97 / $54.22 / $92.20	Professional	TC	$36.97	$54.22	$92.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.66 / $32.22 / $54.65	Professional		$15.66	$32.22	$54.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $17.94	Facility	26	$16.93	$16.93	$17.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $63.15 / $128.09	Professional		$38.08	$63.15	$128.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $14.95 / $31.01	Professional	26	$9.26	$14.95	$31.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $45.78 / $96.71	Professional	TC	$23.26	$45.78	$96.71
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $17.94	Facility	26	$16.93	$16.93	$17.94
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $62.46 / $128.09	Professional		$38.08	$62.46	$128.09
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $16.07 / $34.45	Professional	26	$10.10	$16.07	$34.45
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $24.30 / $42.15 / $91.89	Professional	TC	$24.30	$42.15	$91.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.98 / $36.34 / $51.07	Professional		$26.98	$36.34	$51.07
United Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $51.70 / $98.17	Professional		$36.86	$51.70	$98.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.42 / $16.43 / $30.17	Professional	26	$8.42	$16.43	$30.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.65 / $35.25 / $80.34	Professional	TC	$23.65	$35.25	$80.34