Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $25.12 / $52.48	Professional		$20.89	$25.12	$52.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $19.95 / $25.70	Professional	26	$16.98	$19.95	$25.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $23.99	Professional	TC	$3.02	$3.98	$23.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $45.71 / $95.50	Professional		$26.92	$45.71	$95.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $25.70 / $46.77	Professional	26	$18.62	$25.70	$46.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $4.90 / $12.88 / $47.86	Professional	TC	$4.90	$12.88	$47.86
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.02 / $38.02	Professional		$38.02	$38.02	$38.02
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Professional	26	$31.62	$31.62	$31.62
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $6.31 / $6.31 / $6.31	Professional	TC	$6.31	$6.31	$6.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $4.27 / $4.27 / $4.27	Professional		$4.27	$4.27	$4.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $30.90 / $77.62	Professional		$19.95	$30.90	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.99 / $38.02	Professional	26	$17.38	$23.99	$38.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.31 / $5.01 / $38.02	Professional	TC	$3.31	$5.01	$38.02
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $30.90 / $74.13	Professional		$20.89	$30.90	$74.13
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $24.55 / $38.90	Professional	26	$17.38	$24.55	$38.90
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $3.09 / $5.01 / $38.02	Professional	TC	$3.09	$5.01	$38.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $32.36 / $33.11	Professional		$15.85	$32.36	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $27.54 / $63.10	Professional		$25.12	$27.54	$63.10
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $22.91 / $33.11	Professional	26	$20.89	$22.91	$33.11
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $4.17 / $4.57 / $33.11	Professional	TC	$4.17	$4.57	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $26.92 / $54.95	Professional		$18.20	$26.92	$54.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $19.50 / $32.36	Professional	26	$14.45	$19.50	$32.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.82 / $4.37 / $30.90	Professional	TC	$2.82	$4.37	$30.90