Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.37 / $50.08 / $105.87	Facility	26	$27.37	$50.08	$105.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.69 / $60.03 / $104.33	Professional		$46.69	$60.03	$104.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.57 / $39.58 / $79.89	Professional	26	$26.57	$39.58	$79.89
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.69 / $43.93 / $79.78	Professional	52	$13.69	$43.93	$79.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.23 / $24.75 / $46.28	Professional	TC	$20.23	$24.75	$46.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.64 / $40.89 / $55.33	Professional		$34.64	$40.89	$55.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $26.29 / $47.06	Professional	26	$21.51	$26.29	$47.06
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $9.81 / $9.88 / $21.43	Professional	52	$9.81	$9.88	$21.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $22.85 / $32.89	Professional	TC	$20.42	$22.85	$32.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.82 / $61.52 / $107.31	Professional		$53.82	$61.52	$107.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.81 / $34.90 / $58.66	Professional	26	$29.81	$34.90	$58.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.69 / $27.24 / $47.27	Professional	TC	$23.69	$27.24	$47.27
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $56.77 / $63.02 / $88.04	Professional		$56.77	$63.02	$88.04
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.73 / $35.22 / $49.21	Professional	26	$31.73	$35.22	$49.21
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $25.04 / $27.80 / $38.83	Professional	TC	$25.04	$27.80	$38.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $23.34 / $35.01 / $65.73	Professional		$23.34	$35.01	$65.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $35.20	Facility	26	$32.40	$32.40	$35.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.40 / $69.47 / $113.65	Professional		$45.40	$69.47	$113.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.73 / $38.32 / $63.20	Professional	26	$24.73	$38.32	$63.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.59 / $30.93 / $50.95	Professional	TC	$20.59	$30.93	$50.95
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $35.20	Facility	26	$32.40	$32.40	$35.20
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $44.47 / $64.79 / $110.40	Professional		$44.47	$64.79	$110.40
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $28.24 / $35.32 / $65.50	Professional	26	$28.24	$35.32	$65.50
Medical Mutual of Ohio Facility/Professional Professional Modifier 52 Low / Median / High Price $22.45 / $45.98 / $74.80	Professional	52	$22.45	$45.98	$74.80
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $21.22 / $29.92 / $49.56	Professional	TC	$21.22	$29.92	$49.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $48.62 / $88.90	Professional		$29.82	$48.62	$88.90
United Facility/Professional Professional Modifier Low / Median / High Price $49.06 / $62.32 / $108.96	Professional		$49.06	$62.32	$108.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.30 / $34.35 / $60.38	Professional	26	$27.30	$34.35	$60.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.62 / $27.37 / $47.99	Professional	TC	$21.62	$27.37	$47.99