Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.81 / $49.29 / $104.34	Facility		$10.81	$49.29	$104.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.43 / $10.62 / $26.40	Facility	26	$7.43	$10.62	$26.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.80 / $13.27 / $22.64	Professional		$10.80	$13.27	$22.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.31 / $8.83 / $24.54	Professional	26	$7.31	$8.83	$24.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $11.36 / $11.36 / $11.36	Professional	50	$11.36	$11.36	$11.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.34 / $4.33 / $7.17	Professional	TC	$3.34	$4.33	$7.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.93 / $8.93 / $8.93	Professional		$8.93	$8.93	$8.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.83 / $59.11 / $67.48	Facility		$55.83	$59.11	$67.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.57 / $13.65 / $21.70	Professional		$10.57	$13.65	$21.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $10.38 / $16.64	Professional	26	$8.60	$10.38	$16.64
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $15.85 / $20.47 / $32.56	Professional	50	$15.85	$20.47	$32.56
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1.97 / $2.94 / $5.27	Professional	TC	$1.97	$2.94	$5.27
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3.54 / $8.66 / $14.18	Facility		$3.54	$8.66	$14.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.61 / $9.13 / $14.70	Professional		$3.61	$9.13	$14.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14.18 / $49.99 / $88.00	Facility		$14.18	$49.99	$88.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.64 / $15.28 / $26.35	Professional		$10.64	$15.28	$26.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $10.70 / $17.67	Professional	26	$7.22	$10.70	$17.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.06 / $4.74 / $8.77	Professional	TC	$3.06	$4.74	$8.77
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $15.17 / $49.99 / $88.00	Facility		$15.17	$49.99	$88.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $10.64 / $15.27 / $26.40	Professional		$10.64	$15.27	$26.40
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $10.70 / $17.67	Professional	26	$7.43	$10.70	$17.67
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $3.21 / $4.76 / $9.00	Professional	TC	$3.21	$4.76	$9.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $2.87 / $5.69 / $9.57	Professional		$2.87	$5.69	$9.57
United Facility/Professional Facility Modifier Low / Median / High Price $49.17 / $49.17 / $57.41	Facility		$49.17	$49.17	$57.41
United Facility/Professional Professional Modifier Low / Median / High Price $9.80 / $13.83 / $21.36	Professional		$9.80	$13.83	$21.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.02 / $9.60 / $14.98	Professional	26	$7.02	$9.60	$14.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.76 / $4.37 / $7.20	Professional	TC	$2.76	$4.37	$7.20