Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.19 / $33.40 / $75.18	Facility	26	$20.19	$33.40	$75.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.62 / $63.02 / $115.81	Professional		$53.62	$63.02	$115.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.86 / $20.19 / $42.80	Professional	26	$17.86	$20.19	$42.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.40 / $43.42 / $82.42	Professional	TC	$35.40	$43.42	$82.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.78 / $15.78 / $15.78	Professional	26	$15.78	$15.78	$15.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.65 / $67.02 / $115.27	Professional		$49.65	$67.02	$115.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.75 / $25.98 / $46.38	Professional	26	$22.75	$25.98	$46.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.90 / $39.65 / $68.94	Professional	TC	$26.90	$39.65	$68.94
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $76.88 / $76.88 / $76.88	Professional		$76.88	$76.88	$76.88
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $25.51 / $25.51 / $25.51	Professional	26	$25.51	$25.51	$25.51
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $51.39 / $51.39 / $51.39	Professional	TC	$51.39	$51.39	$51.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.58 / $43.48 / $65.05	Professional		$21.58	$43.48	$65.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $26.77	Facility	26	$23.92	$23.92	$26.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.45 / $82.80 / $141.46	Professional		$55.45	$82.80	$141.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.26 / $27.72 / $47.19	Professional	26	$18.26	$27.72	$47.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.11 / $55.07 / $95.14	Professional	TC	$36.11	$55.07	$95.14
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $26.77	Facility	26	$23.92	$23.92	$26.77
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $56.18 / $82.72 / $132.47	Professional		$56.18	$82.72	$132.47
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $19.87 / $28.21 / $47.15	Professional	26	$19.87	$28.21	$47.15
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $37.54 / $55.34 / $90.92	Professional	TC	$37.54	$55.34	$90.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.98 / $36.24 / $51.35	Professional		$26.98	$36.24	$51.35
United Facility/Professional Professional Modifier Low / Median / High Price $51.70 / $69.76 / $122.06	Professional		$51.70	$69.76	$122.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $24.77 / $45.48	Professional	26	$17.05	$24.77	$45.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.57 / $45.62 / $78.84	Professional	TC	$34.57	$45.62	$78.84