Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $17.00 / $42.04	Facility	26	$10.06	$17.00	$42.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.57 / $35.90 / $162.40	Professional		$28.57	$35.90	$162.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.06 / $13.66 / $35.47	Professional	26	$10.06	$13.66	$35.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $21.58 / $34.51	Professional	TC	$18.19	$21.58	$34.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $36.47 / $48.13	Professional		$25.02	$36.47	$48.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $17.12 / $19.07	Professional	26	$8.77	$17.12	$19.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.30 / $36.46 / $67.01	Professional		$29.30	$36.46	$67.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.79 / $14.74 / $28.44	Professional	26	$11.79	$14.74	$28.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.78 / $22.12 / $40.03	Professional	TC	$16.78	$22.12	$40.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $10.76 / $22.67 / $39.13	Professional		$10.76	$22.67	$39.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $18.64	Facility	26	$11.90	$11.90	$18.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.72 / $40.42 / $68.88	Professional		$28.72	$40.42	$68.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.32 / $15.65 / $27.38	Professional	26	$10.32	$15.65	$27.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.26 / $25.73 / $42.46	Professional	TC	$18.26	$25.73	$42.46
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $18.64	Facility	26	$11.90	$11.90	$18.64
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $28.87 / $39.39 / $63.25	Professional		$28.87	$39.39	$63.25
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.76 / $15.42 / $26.73	Professional	26	$10.76	$15.42	$26.73
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $18.61 / $25.73 / $39.33	Professional	TC	$18.61	$25.73	$39.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $35.58 / $50.72	Professional		$27.10	$35.58	$50.72
United Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $44.66 / $78.65	Professional		$32.04	$44.66	$78.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.79 / $17.05 / $29.57	Professional	26	$11.79	$17.05	$29.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.18 / $26.96 / $49.10	Professional	TC	$19.18	$26.96	$49.10