Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.84 / $74.84 / $74.84	Facility		$74.84	$74.84	$74.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.63 / $28.32 / $77.98	Professional		$24.63	$28.32	$77.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.19 / $10.11 / $23.40	Professional	26	$5.19	$10.11	$23.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.44 / $20.23 / $65.51	Professional	TC	$19.44	$20.23	$65.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.48 / $49.48 / $49.48	Professional		$49.48	$49.48	$49.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.14 / $4.73 / $8.83	Professional	26	$3.14	$4.73	$8.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.20 / $37.06 / $70.83	Professional		$29.20	$37.06	$70.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $8.69 / $16.03	Professional	26	$7.03	$8.69	$16.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.17 / $28.14 / $51.13	Professional	TC	$22.17	$28.14	$51.13
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $20.94 / $23.03 / $24.08	Professional		$20.94	$23.03	$24.08
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $6.94 / $7.26	Professional	26	$6.31	$6.94	$7.26
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $16.53 / $18.18 / $19.01	Professional	TC	$16.53	$18.18	$19.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $27.15 / $40.47	Facility		$6.31	$27.15	$40.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $28.33 / $49.27	Professional		$6.31	$28.33	$49.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.66 / $55.66 / $55.66	Facility		$55.66	$55.66	$55.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.92 / $32.90 / $63.45	Professional		$14.92	$32.90	$63.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.15 / $6.81 / $12.94	Professional	26	$3.15	$6.81	$12.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.56 / $24.41 / $47.23	Professional	TC	$11.56	$24.41	$47.23
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $55.66 / $55.66 / $55.66	Facility		$55.66	$55.66	$55.66
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $14.14 / $32.90 / $64.54	Professional		$14.14	$32.90	$64.54
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $3.15 / $8.83 / $15.46	Professional	26	$3.15	$8.83	$15.46
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $11.56 / $24.79 / $47.23	Professional	TC	$11.56	$24.79	$47.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.34 / $36.50 / $53.74	Professional		$21.34	$36.50	$53.74
United Facility/Professional Professional Modifier Low / Median / High Price $17.53 / $29.22 / $54.02	Professional		$17.53	$29.22	$54.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.83 / $7.05 / $12.84	Professional	26	$3.83	$7.05	$12.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.30 / $22.84 / $40.99	Professional	TC	$13.30	$22.84	$40.99