Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $16.98 / $40.74	Professional		$13.80	$16.98	$40.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $24.55 / $77.62	Professional	26	$8.91	$24.55	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.25 / $7.08 / $17.38	Professional	TC	$5.25	$7.08	$17.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $5.89 / $11.75	Professional	26	$5.62	$5.89	$11.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $11.75 / $33.88	Professional		$9.12	$11.75	$33.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $7.24 / $21.38	Professional	26	$5.37	$7.24	$21.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $4.68 / $11.22	Professional	TC	$3.72	$4.68	$11.22
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $15.14 / $33.88	Professional		$13.18	$15.14	$33.88
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $13.18 / $20.42	Professional	26	$11.22	$13.18	$20.42
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $5.25 / $6.03 / $14.13	Professional	TC	$5.25	$6.03	$14.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.59 / $13.18 / $25.70	Facility		$7.59	$13.18	$25.70
CareSource Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $15.14 / $26.92	Professional		$7.41	$15.14	$26.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $19.95 / $38.90	Facility		$17.38	$19.95	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $18.62 / $30.90	Professional		$9.33	$18.62	$30.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $11.22 / $20.89	Professional	26	$5.62	$11.22	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $5.62 / $12.30	Professional	TC	$3.72	$5.62	$12.30
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $17.78 / $17.78	Facility		$17.78	$17.78	$17.78
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $16.98 / $37.15	Professional		$9.33	$16.98	$37.15
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $15.85 / $26.30	Professional	26	$5.62	$15.85	$26.30
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $3.72 / $4.79 / $12.30	Professional	TC	$3.72	$4.79	$12.30
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 $19.50 / $26.30 / $43.65	Professional		$19.50	$26.30	$43.65
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.98 / $25.70	Professional	26	$11.75	$16.98	$25.70
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $7.94 / $10.23 / $17.78	Professional	TC	$7.94	$10.23	$17.78
United Facility/Professional Facility Modifier Low / Median / High Price $7.24 / $10.96 / $18.20	Facility		$7.24	$10.96	$18.20
United Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $19.50 / $33.11	Professional		$10.47	$19.50	$33.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $12.02 / $19.05	Professional	26	$6.76	$12.02	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.47 / $7.59 / $13.18	Professional	TC	$3.47	$7.59	$13.18