Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.33 / $20.89 / $63.10	Facility		$9.33	$20.89	$63.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $10.47 / $26.30	Facility	26	$7.41	$10.47	$26.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $15.49 / $39.81	Professional		$9.77	$15.49	$39.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $25.70	Professional	26	$6.03	$8.91	$25.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.48 / $11.48 / $11.48	Professional	50	$11.48	$11.48	$11.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.29 / $3.98 / $7.41	Professional	TC	$2.29	$3.98	$7.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $9.77 / $16.98	Professional		$8.13	$9.77	$16.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.23 / $10.23	Professional	26	$10.23	$10.23	$10.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $66.07 / $67.61	Facility		$57.54	$66.07	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $14.79 / $22.91	Professional		$10.96	$14.79	$22.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $18.20	Professional	26	$8.51	$11.48	$18.20
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $16.60 / $21.88 / $34.67	Professional	50	$16.60	$21.88	$34.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $2.29 / $3.24 / $5.50	Professional	TC	$2.29	$3.24	$5.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.63 / $9.33 / $17.38	Facility		$3.63	$9.33	$17.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.47 / $8.71 / $14.45	Professional		$3.47	$8.71	$14.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3.55 / $15.49 / $61.66	Facility		$3.55	$15.49	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $15.14 / $25.70	Professional		$10.72	$15.14	$25.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.72 / $17.78	Professional	26	$7.08	$10.72	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.88 / $4.79 / $8.32	Professional	TC	$2.88	$4.79	$8.32
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $14.13 / $51.29 / $81.28	Facility		$14.13	$51.29	$81.28
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $15.14 / $26.30	Professional		$10.23	$15.14	$26.30
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.47 / $17.78	Professional	26	$6.92	$10.47	$17.78
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $2.88 / $4.57 / $8.32	Professional	TC	$2.88	$4.57	$8.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.75 / $32.36 / $33.11	Professional		$5.75	$32.36	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $35.48	Facility		$35.48	$35.48	$35.48
SummaCare Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $35.48 / $35.48	Facility	26	$35.48	$35.48	$35.48
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $14.45 / $25.70	Professional		$11.75	$14.45	$25.70
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.77 / $17.38	Professional	26	$7.76	$9.77	$17.38
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $3.89 / $4.79 / $8.51	Professional	TC	$3.89	$4.79	$8.51
United Facility/Professional Facility Modifier Low / Median / High Price $2.63 / $18.62 / $83.18	Facility		$2.63	$18.62	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $13.18 / $20.89	Professional		$9.55	$13.18	$20.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.12 / $14.13	Professional	26	$6.61	$9.12	$14.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.63 / $4.07 / $6.76	Professional	TC	$2.63	$4.07	$6.76