Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.13 / $36.58 / $89.18	Facility	26	$26.13	$36.58	$89.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.77 / $79.53 / $155.57	Professional		$53.77	$79.53	$155.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.20 / $32.78 / $90.45	Professional	26	$24.20	$32.78	$90.45
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.68 / $29.22 / $71.17	Professional	52	$25.68	$29.22	$71.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.64 / $48.12 / $96.65	Professional	TC	$27.64	$48.12	$96.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.79 / $45.77 / $95.04	Professional		$43.79	$45.77	$95.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.88 / $23.13 / $42.57	Professional	26	$6.88	$23.13	$42.57
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $10.95 / $40.04 / $107.71	Professional	52	$10.95	$40.04	$107.71
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $22.74 / $22.74	Professional	TC	$22.74	$22.74	$22.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.06 / $83.76 / $135.76	Professional		$69.06	$83.76	$135.76
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.70 / $33.24 / $51.11	Professional	26	$27.70	$33.24	$51.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.75 / $48.28 / $87.44	Professional	TC	$36.75	$48.28	$87.44
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $62.69 / $62.69 / $69.06	Professional		$62.69	$62.69	$69.06
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $30.31 / $30.31 / $33.40	Professional	26	$30.31	$30.31	$33.40
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $32.38 / $32.38 / $35.67	Professional	TC	$32.38	$32.38	$35.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.44 / $37.21 / $71.73	Professional		$27.44	$37.21	$71.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.44 / $86.43 / $152.65	Professional		$58.44	$86.43	$152.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.40 / $35.46 / $56.03	Professional	26	$24.40	$35.46	$56.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.19 / $54.79 / $99.94	Professional	TC	$30.19	$54.79	$99.94
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $58.44 / $84.45 / $151.75	Professional		$58.44	$84.45	$151.75
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $25.81 / $36.34 / $59.08	Professional	26	$25.81	$36.34	$59.08
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $30.95 / $49.34 / $99.74	Professional	TC	$30.95	$49.34	$99.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $48.31 / $88.82	Professional		$29.46	$48.31	$88.82
United Facility/Professional Professional Modifier Low / Median / High Price $63.12 / $85.78 / $137.52	Professional		$63.12	$85.78	$137.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.88 / $31.39 / $51.62	Professional	26	$22.88	$31.39	$51.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $55.56 / $84.74	Professional	TC	$37.15	$55.56	$84.74