Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.67 / $25.01 / $49.76	Facility	26	$13.67	$25.01	$49.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $51.24 / $97.57	Professional		$43.95	$51.24	$97.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.37 / $14.06 / $26.51	Professional	26	$12.37	$14.06	$26.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.22 / $37.71 / $69.03	Professional	TC	$32.22	$37.71	$69.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.03 / $40.03 / $51.22	Professional		$40.03	$40.03	$51.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.62 / $10.62 / $10.82	Professional	26	$10.62	$10.62	$10.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $59.92 / $105.48	Professional		$51.31	$59.92	$105.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.51 / $16.76 / $30.01	Professional	26	$12.51	$16.76	$30.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.82 / $44.01 / $77.03	Professional	TC	$37.82	$44.01	$77.03
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $57.49 / $57.49 / $57.49	Professional		$57.49	$57.49	$57.49
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $15.67 / $15.67 / $15.67	Professional	26	$15.67	$15.67	$15.67
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $41.82 / $41.82 / $41.82	Professional	TC	$41.82	$41.82	$41.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.61 / $38.97 / $53.59	Professional		$14.61	$38.97	$53.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $17.72	Facility	26	$16.20	$16.20	$17.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.30 / $68.20 / $112.16	Professional		$45.30	$68.20	$112.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $19.14 / $32.61	Professional	26	$12.39	$19.14	$32.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.86 / $49.62 / $81.36	Professional	TC	$32.86	$49.62	$81.36
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $17.72	Facility	26	$16.20	$16.20	$17.72
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $47.27 / $66.20 / $109.22	Professional		$47.27	$66.20	$109.22
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $13.46 / $19.61 / $32.61	Professional	26	$13.46	$19.61	$32.61
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $33.93 / $49.62 / $80.20	Professional	TC	$33.93	$49.62	$80.20
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 $41.53 / $58.32 / $106.98	Professional		$41.53	$58.32	$106.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.89 / $16.78 / $30.42	Professional	26	$11.89	$16.78	$30.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.78 / $42.82 / $85.45	Professional	TC	$29.78	$42.82	$85.45