Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $43.49 / $114.51	Professional		$41.69	$43.49	$114.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.41 / $34.77 / $120.39	Professional	26	$26.41	$34.77	$120.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.80 / $15.87 / $39.24	Professional	TC	$15.80	$15.87	$39.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.93 / $25.93 / $25.93	Professional		$25.93	$25.93	$25.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.16 / $17.50 / $42.10	Professional	26	$16.16	$17.50	$42.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $30.46 / $85.07	Professional		$23.62	$30.46	$85.07
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.26 / $20.29 / $54.33	Professional	26	$15.26	$20.29	$54.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.35 / $10.59 / $30.74	Professional	TC	$8.35	$10.59	$30.74
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $39.94 / $41.76 / $94.92	Professional		$39.94	$41.76	$94.92
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $35.61 / $37.24 / $59.26	Professional	26	$35.61	$37.24	$59.26
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $15.00 / $15.69 / $35.67	Professional	TC	$15.00	$15.69	$35.67
CareSource Facility/Professional Professional Modifier Low / Median / High Price $19.54 / $42.09 / $76.06	Professional		$19.54	$42.09	$76.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.93 / $51.87 / $87.32	Professional		$25.93	$51.87	$87.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.19 / $32.38 / $60.06	Professional	26	$16.19	$32.38	$60.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.36 / $17.75 / $32.15	Professional	TC	$9.36	$17.75	$32.15
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $25.93 / $51.87 / $100.16	Professional		$25.93	$51.87	$100.16
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $16.19 / $37.22 / $72.93	Professional	26	$16.19	$37.22	$72.93
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $9.36 / $18.07 / $34.52	Professional	TC	$9.36	$18.07	$34.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $46.36 / $89.50	Professional		$28.15	$46.36	$89.50
United Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $54.39 / $99.04	Professional		$32.63	$54.39	$99.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $35.99 / $56.30	Professional	26	$19.60	$35.99	$56.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $17.88 / $32.56	Professional	TC	$10.72	$17.88	$32.56