Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.75 / $35.54 / $84.46	Facility	26	$22.75	$35.54	$84.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.88 / $50.29 / $261.00	Professional		$40.88	$50.29	$261.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $25.64 / $117.00	Professional	26	$21.37	$25.64	$117.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.10 / $43.59	Professional	TC	$18.82	$23.10	$43.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $41.22 / $48.50	Professional		$31.57	$41.22	$48.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $28.74 / $33.22	Professional	26	$18.30	$28.74	$33.22
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.68 / $14.68 / $14.68	Professional	TC	$14.68	$14.68	$14.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.71 / $64.67 / $100.97	Professional		$49.71	$64.67	$100.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.61 / $30.83 / $49.72	Professional	26	$25.61	$30.83	$49.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.83 / $31.28 / $52.79	Professional	TC	$22.83	$31.28	$52.79
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $47.70 / $52.55 / $52.95	Professional		$47.70	$52.55	$52.95
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $26.09 / $28.74 / $28.96	Professional	26	$26.09	$28.74	$28.96
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $21.61 / $23.80 / $23.99	Professional	TC	$21.61	$23.80	$23.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.14 / $29.85 / $54.57	Professional		$20.14	$29.85	$54.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.42 / $62.31 / $116.68	Professional		$40.42	$62.31	$116.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.66 / $31.31 / $49.95	Professional	26	$21.66	$31.31	$49.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.30 / $28.81 / $63.26	Professional	TC	$18.30	$28.81	$63.26
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $40.97 / $60.00 / $114.58	Professional		$40.97	$60.00	$114.58
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $22.95 / $32.75 / $58.76	Professional	26	$22.95	$32.75	$58.76
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $18.57 / $27.62 / $61.46	Professional	TC	$18.57	$27.62	$61.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.39 / $47.95 / $88.82	Professional		$29.39	$47.95	$88.82
United Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $53.97 / $86.91	Professional		$39.38	$53.97	$86.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $27.82 / $44.82	Professional	26	$20.50	$27.82	$44.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $24.22 / $48.35	Professional	TC	$17.89	$24.22	$48.35