Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.68 / $18.13 / $47.30	Facility	26	$12.68	$18.13	$47.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $43.33 / $86.44	Professional		$34.85	$43.33	$86.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.73 / $14.58 / $28.07	Professional	26	$11.73	$14.58	$28.07
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.28 / $21.07 / $37.27	Professional	52	$15.28	$21.07	$37.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $29.46 / $59.46	Professional	TC	$22.26	$29.46	$59.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $35.74 / $84.60	Professional		$35.74	$35.74	$84.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $17.25 / $20.42	Professional	26	$9.86	$17.25	$20.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.25 / $43.95 / $73.91	Professional		$35.25	$43.95	$73.91
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.32 / $15.99 / $28.02	Professional	26	$13.32	$15.99	$28.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.93 / $27.37 / $47.22	Professional	TC	$21.93	$27.37	$47.22
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $48.31 / $48.31 / $48.31	Professional		$48.31	$48.31	$48.31
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $14.54 / $14.54 / $14.54	Professional	26	$14.54	$14.54	$14.54
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $33.77 / $33.77 / $33.77	Professional	TC	$33.77	$33.77	$33.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.55 / $35.99 / $57.32	Professional		$13.55	$35.99	$57.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $16.80	Facility	26	$14.96	$14.96	$16.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.21 / $51.94 / $91.71	Professional		$36.21	$51.94	$91.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $17.46 / $30.27	Professional	26	$11.74	$17.46	$30.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.49 / $34.35 / $64.12	Professional	TC	$24.49	$34.35	$64.12
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $16.80	Facility	26	$14.96	$14.96	$16.80
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $35.61 / $51.94 / $85.98	Professional		$35.61	$51.94	$85.98
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $12.32 / $17.92 / $32.79	Professional	26	$12.32	$17.92	$32.79
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $25.87 / $34.92 / $60.11	Professional	TC	$25.87	$34.92	$60.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $36.24 / $51.07	Professional		$26.52	$36.24	$51.07
United Facility/Professional Professional Modifier Low / Median / High Price $32.67 / $46.48 / $81.94	Professional		$32.67	$46.48	$81.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.47 / $16.00 / $29.99	Professional	26	$11.47	$16.00	$29.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.18 / $32.04 / $59.74	Professional	TC	$21.18	$32.04	$59.74