Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.96 / $40.63 / $80.98	Facility	26	$30.96	$40.63	$80.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.64 / $59.86 / $162.97	Professional		$28.64	$59.86	$162.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.60 / $36.58 / $90.44	Professional	26	$18.60	$36.58	$90.44
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.33 / $69.77 / $69.90	Professional	50	$33.33	$69.77	$69.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.10 / $28.24 / $54.79	Professional	TC	$9.10	$28.24	$54.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.52 / $50.88 / $91.54	Professional		$44.52	$50.88	$91.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.32 / $30.76 / $46.80	Professional	26	$24.32	$30.76	$46.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $25.02 / $29.00	Professional	TC	$23.23	$25.02	$29.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.77 / $42.88 / $76.77	Professional		$32.77	$42.88	$76.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.19 / $28.59 / $49.29	Professional	26	$22.19	$28.59	$49.29
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $50.62 / $65.41 / $115.16	Professional	50	$50.62	$65.41	$115.16
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.21 / $13.76 / $32.92	Professional	TC	$10.21	$13.76	$32.92
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $69.69 / $69.69 / $76.78	Professional		$69.69	$69.69	$76.78
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $36.60 / $36.60 / $40.33	Professional	26	$36.60	$36.60	$40.33
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $33.08 / $33.08 / $36.44	Professional	TC	$33.08	$33.08	$36.44
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $42.05 / $79.73	Professional		$30.40	$42.05	$79.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.20 / $59.06 / $104.83	Professional		$35.20	$59.06	$104.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.43 / $35.65 / $53.29	Professional	26	$22.43	$35.65	$53.29
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.87 / $74.87 / $84.74	Professional	50	$74.87	$74.87	$84.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $27.16 / $52.18	Professional	TC	$11.75	$27.16	$52.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $35.61 / $62.00 / $117.30	Professional		$35.61	$62.00	$117.30
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $22.57 / $37.22 / $63.46	Professional	26	$22.57	$37.22	$63.46
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $12.24 / $27.99 / $52.18	Professional	TC	$12.24	$27.99	$52.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $47.95 / $88.82	Professional		$29.19	$47.95	$88.82
United Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $58.10 / $98.88	Professional		$31.84	$58.10	$98.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.73 / $27.66 / $45.27	Professional	26	$18.73	$27.66	$45.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.19 / $31.54 / $55.31	Professional	TC	$10.19	$31.54	$55.31