Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.03 / $39.39 / $78.33	Facility	26	$22.03	$39.39	$78.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.75 / $69.65 / $147.76	Professional		$35.75	$69.65	$147.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.03 / $30.07 / $50.89	Professional	26	$22.03	$30.07	$50.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.72 / $29.09 / $82.16	Professional	TC	$13.72	$29.09	$82.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $37.79 / $37.79	Professional		$37.79	$37.79	$37.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.07 / $23.04 / $35.01	Professional	26	$18.07	$23.04	$35.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.79 / $82.53 / $126.90	Professional		$58.79	$82.53	$126.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.67 / $33.24 / $50.54	Professional	26	$27.67	$33.24	$50.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.36 / $47.59 / $78.44	Professional	TC	$21.36	$47.59	$78.44
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $68.92 / $68.92 / $68.92	Professional		$68.92	$68.92	$68.92
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $41.34 / $41.34 / $41.34	Professional	26	$41.34	$41.34	$41.34
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $27.58 / $27.58 / $27.58	Professional	TC	$27.58	$27.58	$27.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $17.23 / $29.37 / $51.91	Professional		$17.23	$29.37	$51.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.47 / $37.47 / $37.47	Facility	26	$37.47	$37.47	$37.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.43 / $63.17 / $140.88	Professional		$39.43	$63.17	$140.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.59 / $31.93 / $57.72	Professional	26	$22.59	$31.93	$57.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.37 / $25.33 / $82.53	Professional	TC	$15.37	$25.33	$82.53
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $37.47 / $37.47 / $37.47	Facility	26	$37.47	$37.47	$37.47
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $41.42 / $63.17 / $142.69	Professional		$41.42	$63.17	$142.69
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $32.52 / $59.72	Professional	26	$22.74	$32.52	$59.72
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $16.57 / $23.12 / $89.49	Professional	TC	$16.57	$23.12	$89.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.88 / $37.06 / $51.35	Professional		$27.88	$37.06	$51.35
United Facility/Professional Professional Modifier Low / Median / High Price $42.83 / $62.89 / $106.13	Professional		$42.83	$62.89	$106.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.36 / $27.98 / $46.23	Professional	26	$18.36	$27.98	$46.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.43 / $29.00 / $65.03	Professional	TC	$16.43	$29.00	$65.03