Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.62 / $18.64 / $26.69	Facility	26	$13.62	$18.64	$26.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $39.86 / $69.83	Professional		$17.14	$39.86	$69.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.32 / $14.65 / $28.93	Professional	26	$7.32	$14.65	$28.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.11 / $25.21 / $47.04	Professional	TC	$10.11	$25.21	$47.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.83 / $43.49 / $80.11	Professional		$38.83	$43.49	$80.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.39 / $14.32 / $24.90	Professional	26	$11.39	$14.32	$24.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.32 / $24.35 / $51.37	Professional		$19.32	$24.35	$51.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.40 / $10.90 / $20.77	Professional	26	$8.40	$10.90	$20.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.92 / $13.60 / $32.57	Professional	TC	$10.92	$13.60	$32.57
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $46.04 / $46.04	Professional		$46.04	$46.04	$46.04
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $16.79 / $16.79 / $16.79	Professional	26	$16.79	$16.79	$16.79
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $29.25 / $29.25	Professional	TC	$29.25	$29.25	$29.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.65 / $32.22 / $54.63	Professional		$15.65	$32.22	$54.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.48 / $17.32 / $17.32	Facility	26	$9.48	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.57 / $39.00 / $80.00	Professional		$21.57	$39.00	$80.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $14.63 / $29.18	Professional	26	$8.85	$14.63	$29.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.90 / $23.89 / $52.06	Professional	TC	$11.90	$23.89	$52.06
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $9.48 / $9.48 / $17.32	Facility	26	$9.48	$9.48	$17.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $19.93 / $40.67 / $73.28	Professional		$19.93	$40.67	$73.28
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.14 / $16.37 / $29.89	Professional	26	$10.14	$16.37	$29.89
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $12.25 / $26.67 / $49.47	Professional	TC	$12.25	$26.67	$49.47
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 $17.23 / $41.49 / $80.29	Professional		$17.23	$41.49	$80.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.40 / $16.16 / $29.24	Professional	26	$7.40	$16.16	$29.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.02 / $26.41 / $49.66	Professional	TC	$9.02	$26.41	$49.66