Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $37.15 / $97.72	Professional		$23.99	$37.15	$97.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $14.45 / $41.69	Professional	26	$5.01	$14.45	$41.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $58.88	Professional	TC	$15.14	$21.88	$58.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $6.76 / $11.22	Professional	26	$6.76	$6.76	$11.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $35.48 / $72.44	Professional		$29.51	$35.48	$72.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $8.71 / $16.22	Professional	26	$7.08	$8.71	$16.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.92 / $51.29	Professional	TC	$22.39	$26.92	$51.29
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $23.99 / $54.95	Professional		$20.89	$23.99	$54.95
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $7.24 / $12.02	Professional	26	$6.31	$7.24	$12.02
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $19.05 / $42.66	Professional	TC	$16.60	$19.05	$42.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.46 / $23.99 / $40.74	Facility		$6.46	$23.99	$40.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $28.18 / $56.23	Professional		$6.31	$28.18	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $57.54 / $75.86	Facility		$11.48	$57.54	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $30.90 / $58.88	Professional		$14.79	$30.90	$58.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $6.61 / $12.30	Professional	26	$3.16	$6.61	$12.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $23.44 / $43.65	Professional	TC	$11.48	$23.44	$43.65
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Facility		$56.23	$56.23	$56.23
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $31.62 / $64.57	Professional		$14.45	$31.62	$64.57
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $8.71 / $14.79	Professional	26	$3.16	$8.71	$14.79
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $23.44 / $45.71	Professional	TC	$11.48	$23.44	$45.71
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 $31.62 / $41.69 / $74.13	Professional		$31.62	$41.69	$74.13
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.91 / $15.14	Professional	26	$6.92	$8.91	$15.14
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $32.36 / $61.66	Professional	TC	$24.55	$32.36	$61.66
United Facility/Professional Facility Modifier Low / Median / High Price $10.00 / $15.14 / $25.12	Facility		$10.00	$15.14	$25.12
United Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $29.51 / $53.70	Professional		$17.38	$29.51	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.89 / $6.92 / $10.47	Professional	26	$3.89	$6.92	$10.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $22.91 / $40.74	Professional	TC	$13.18	$22.91	$40.74