Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.11 / $12.76 / $32.40	Facility	26	$9.11	$12.76	$32.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.08 / $57.11 / $126.55	Professional		$34.08	$57.11	$126.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $10.92 / $29.71	Professional	26	$8.86	$10.92	$29.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.41 / $36.60 / $101.25	Professional	TC	$24.41	$36.60	$101.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.34 / $30.11 / $46.06	Professional		$28.34	$30.11	$46.06
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $8.91 / $14.19	Professional	26	$7.00	$8.91	$14.19
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $28.41 / $41.17	Professional	TC	$22.01	$28.41	$41.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.19 / $86.34 / $141.40	Professional		$51.19	$86.34	$141.40
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.81 / $15.61 / $33.90	Professional	26	$10.81	$15.61	$33.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.52 / $59.04 / $109.22	Professional	TC	$34.52	$59.04	$109.22
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $41.81 / $41.81 / $41.81	Professional		$41.81	$41.81	$41.81
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.47 / $10.47	Professional	26	$10.47	$10.47	$10.47
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $31.34 / $31.34 / $31.34	Professional	TC	$31.34	$31.34	$31.34
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.76 / $33.38 / $49.61	Professional		$9.76	$33.38	$49.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $11.60	Facility	26	$10.80	$10.80	$11.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.46 / $59.08 / $138.93	Professional		$34.46	$59.08	$138.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $12.73 / $21.32	Professional	26	$8.60	$12.73	$21.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.49 / $45.00 / $118.38	Professional	TC	$25.49	$45.00	$118.38
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $11.60	Facility	26	$10.80	$10.80	$11.60
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $34.06 / $56.68 / $133.97	Professional		$34.06	$56.68	$133.97
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $14.71 / $28.42	Professional	26	$9.11	$14.71	$28.42
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $26.08 / $43.82 / $118.38	Professional	TC	$26.08	$43.82	$118.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.98 / $36.24 / $51.07	Professional		$26.98	$36.24	$51.07
United Facility/Professional Professional Modifier Low / Median / High Price $33.75 / $48.07 / $100.87	Professional		$33.75	$48.07	$100.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $10.67 / $20.22	Professional	26	$7.79	$10.67	$20.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $35.56 / $74.80	Professional	TC	$23.19	$35.56	$74.80