Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.92 / $22.77 / $53.10	Facility	26	$15.92	$22.77	$53.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $43.86 / $77.67	Professional		$34.54	$43.86	$77.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.08 / $15.92 / $29.45	Professional	26	$14.08	$15.92	$29.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.40 / $27.94 / $48.67	Professional	TC	$22.40	$27.94	$48.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.01 / $36.01 / $76.20	Professional		$36.01	$36.01	$76.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.13 / $20.11 / $21.66	Professional	26	$12.13	$20.11	$21.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.84 / $49.76 / $84.25	Professional		$40.84	$49.76	$84.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.44 / $18.98 / $32.47	Professional	26	$15.44	$18.98	$32.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.40 / $30.54 / $53.08	Professional	TC	$25.40	$30.54	$53.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.02 / $29.22 / $46.23	Professional		$17.02	$29.22	$46.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.93	Facility	26	$18.82	$18.82	$18.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.65 / $57.01 / $98.54	Professional		$37.65	$57.01	$98.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.82 / $21.56 / $36.77	Professional	26	$13.82	$21.56	$36.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.13 / $35.85 / $64.56	Professional	TC	$24.13	$35.85	$64.56
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.93	Facility	26	$18.82	$18.82	$18.93
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $37.19 / $56.40 / $96.74	Professional		$37.19	$56.40	$96.74
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $15.47 / $21.99 / $42.84	Professional	26	$15.47	$21.99	$42.84
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $24.50 / $34.84 / $64.56	Professional	TC	$24.50	$34.84	$64.56
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 $34.88 / $50.85 / $87.52	Professional		$34.88	$50.85	$87.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $18.89 / $33.59	Professional	26	$13.88	$18.89	$33.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.12 / $31.21 / $54.87	Professional	TC	$20.12	$31.21	$54.87