Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.21 / $34.17 / $58.43	Professional		$26.21	$34.17	$58.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.58 / $15.42 / $22.87	Professional	26	$12.58	$15.42	$22.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.22 / $17.03 / $35.28	Professional	TC	$13.22	$17.03	$35.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $35.88 / $36.77	Professional		$28.28	$35.88	$36.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.96 / $49.26 / $92.77	Professional		$30.96	$49.26	$92.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.77 / $18.07 / $29.88	Professional	26	$13.77	$18.07	$29.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $30.86 / $58.74	Professional	TC	$15.59	$30.86	$58.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.97 / $23.26 / $12,653.35	Facility		$15.97	$23.26	$12,653.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.23 / $20.36 / $42.57	Professional		$16.23	$20.36	$42.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.85 / $38.01 / $84.23	Professional		$25.85	$38.01	$84.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.54 / $17.73 / $31.39	Professional	26	$12.54	$17.73	$31.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.31 / $19.57 / $45.85	Professional	TC	$13.31	$19.57	$45.85
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $25.85 / $37.90 / $82.56	Professional		$25.85	$37.90	$82.56
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $12.54 / $17.79 / $31.39	Professional	26	$12.54	$17.79	$31.39
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $13.31 / $19.57 / $45.41	Professional	TC	$13.31	$19.57	$45.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $36.34 / $52.62	Professional		$25.04	$36.34	$52.62
United Facility/Professional Professional Modifier Low / Median / High Price $22.97 / $31.89 / $59.32	Professional		$22.97	$31.89	$59.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.29 / $14.94 / $26.18	Professional	26	$11.29	$14.94	$26.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.38 / $17.01 / $33.03	Professional	TC	$12.38	$17.01	$33.03