Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.41 / $24.41 / $24.41	Facility	TC	$24.41	$24.41	$24.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.72 / $16.03 / $33.08	Professional		$13.72	$16.03	$33.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.09 / $14.27 / $34.07	Professional	26	$9.09	$14.27	$34.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $6.18 / $6.57 / $14.24	Professional	TC	$6.18	$6.57	$14.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.59 / $13.59 / $32.00	Professional		$13.59	$13.59	$32.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.63 / $7.84 / $15.88	Professional	26	$5.63	$7.84	$15.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.07 / $11.70 / $31.48	Professional		$9.07	$11.70	$31.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.33 / $7.08 / $20.03	Professional	26	$5.33	$7.08	$20.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.74 / $4.74 / $11.11	Professional	TC	$3.74	$4.74	$11.11
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $14.44 / $14.44 / $34.31	Professional		$14.44	$14.44	$34.31
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $12.47 / $12.47 / $20.75	Professional	26	$12.47	$12.47	$20.75
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $5.71 / $5.71 / $13.56	Professional	TC	$5.71	$5.71	$13.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.50 / $14.08 / $25.59	Facility		$7.50	$14.08	$25.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $14.74 / $27.22	Professional		$7.41	$14.74	$27.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.85 / $17.85 / $17.85	Facility		$17.85	$17.85	$17.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.36 / $18.75 / $32.92	Professional		$9.36	$18.75	$32.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $11.34 / $20.82	Professional	26	$5.67	$11.34	$20.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.70 / $6.00 / $12.22	Professional	TC	$3.70	$6.00	$12.22
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $17.85 / $17.85 / $17.85	Facility		$17.85	$17.85	$17.85
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $9.36 / $18.75 / $36.97	Professional		$9.36	$18.75	$36.97
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $5.67 / $15.31 / $28.87	Professional	26	$5.67	$15.31	$28.87
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $3.70 / $7.12 / $13.82	Professional	TC	$3.70	$7.12	$13.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $7.10 / $10.62 / $17.73	Professional		$7.10	$10.62	$17.73
United Facility/Professional Professional Modifier Low / Median / High Price $12.19 / $20.98 / $35.67	Professional		$12.19	$20.98	$35.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.99 / $12.61 / $19.48	Professional	26	$6.99	$12.61	$19.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.44 / $8.08 / $12.11	Professional	TC	$3.44	$8.08	$12.11