Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $15.14 / $50.12	Professional		$10.96	$15.14	$50.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $7.41 / $23.44	Professional	26	$3.02	$7.41	$23.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.92 / $10.23 / $30.20	Professional	TC	$6.92	$10.23	$30.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.04 / $2.19 / $4.47	Professional	26	$2.04	$2.19	$4.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $18.20 / $35.48	Professional		$15.14	$18.20	$35.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.57 / $5.75 / $10.47	Professional	26	$4.57	$5.75	$10.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $12.30 / $23.99	Professional	TC	$10.72	$12.30	$23.99
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $12.02 / $30.90	Professional		$10.47	$12.02	$30.90
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $4.07 / $4.68 / $8.51	Professional	26	$4.07	$4.68	$8.51
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $7.59 / $8.71 / $22.39	Professional	TC	$7.59	$8.71	$22.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.17 / $12.59 / $20.42	Facility		$4.17	$12.59	$20.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4.07 / $13.18 / $26.30	Professional		$4.07	$13.18	$26.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $29.51 / $34.67	Facility		$25.12	$29.51	$34.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $15.85 / $28.84	Professional		$7.59	$15.85	$28.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.04 / $4.27 / $7.59	Professional	26	$2.04	$4.27	$7.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $5.50 / $10.96 / $19.05	Professional	TC	$5.50	$10.96	$19.05
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Facility		$25.12	$25.12	$25.12
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $16.60 / $30.90	Professional		$7.41	$16.60	$30.90
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $2.04 / $5.37 / $10.72	Professional	26	$2.04	$5.37	$10.72
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $5.50 / $10.96 / $19.95	Professional	TC	$5.50	$10.96	$19.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $20.89 / $36.31	Professional		$15.85	$20.89	$36.31
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $4.47 / $5.75 / $9.77	Professional	26	$4.47	$5.75	$9.77
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $15.14 / $26.92	Professional	TC	$11.48	$15.14	$26.92
United Facility/Professional Facility Modifier Low / Median / High Price $5.25 / $7.94 / $13.18	Facility		$5.25	$7.94	$13.18
United Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $14.79 / $26.92	Professional		$8.91	$14.79	$26.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.51 / $4.27 / $6.76	Professional	26	$2.51	$4.27	$6.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $6.17 / $10.47 / $19.05	Professional	TC	$6.17	$10.47	$19.05