Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $41.01 / $113.18	Professional		$34.54	$41.01	$113.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.78 / $25.06 / $191.32	Professional	26	$22.78	$25.06	$191.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.92 / $18.23 / $47.47	Professional	TC	$10.92	$18.23	$47.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.98 / $31.06 / $39.14	Professional	26	$13.98	$31.06	$39.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.90 / $51.73 / $99.36	Professional		$37.90	$51.73	$99.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.80 / $37.61 / $71.02	Professional	26	$26.80	$37.61	$71.02
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.41 / $11.94 / $28.20	Professional	TC	$9.41	$11.94	$28.20
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $38.58 / $38.58 / $91.68	Professional		$38.58	$38.58	$91.68
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $30.76 / $30.76 / $51.17	Professional	26	$30.76	$30.76	$51.17
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $17.05 / $40.52	Professional	TC	$17.05	$17.05	$40.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.74 / $51.11 / $77.66	Facility		$25.74	$51.11	$77.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.81 / $52.81 / $52.81	Facility		$52.81	$52.81	$52.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.05 / $48.67 / $79.23	Professional		$25.05	$48.67	$79.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.98 / $28.39 / $51.97	Professional	26	$13.98	$28.39	$51.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $7.68 / $12.15 / $35.42	Professional	TC	$7.68	$12.15	$35.42
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $52.81 / $52.81 / $52.81	Facility		$52.81	$52.81	$52.81
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $25.05 / $50.10 / $82.67	Professional		$25.05	$50.10	$82.67
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $13.98 / $32.15 / $57.33	Professional	26	$13.98	$32.15	$57.33
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $7.68 / $13.04 / $36.53	Professional	TC	$7.68	$13.04	$36.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $46.40 / $89.59	Professional		$28.15	$46.40	$89.59
United Facility/Professional Professional Modifier Low / Median / High Price $31.66 / $52.76 / $96.08	Professional		$31.66	$52.76	$96.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $29.68 / $53.70	Professional	26	$17.57	$29.68	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.86 / $20.85 / $39.15	Professional	TC	$8.86	$20.85	$39.15