Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $28.84 / $64.57	Professional		$23.99	$28.84	$64.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.99 / $32.36	Professional	26	$19.05	$23.99	$32.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $3.98 / $29.51	Professional	TC	$3.02	$3.98	$29.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $33.11	Professional		$27.54	$27.54	$33.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $46.77 / $97.72	Professional		$27.54	$46.77	$97.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $22.39 / $38.90	Professional	26	$15.49	$22.39	$38.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $4.68 / $19.50 / $56.23	Professional	TC	$4.68	$19.50	$56.23
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $43.65 / $43.65	Professional		$43.65	$43.65	$43.65
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $38.02 / $38.02	Professional	26	$38.02	$38.02	$38.02
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $5.89 / $5.89 / $5.89	Professional	TC	$5.89	$5.89	$5.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.98 / $3.98 / $3.98	Professional		$3.98	$3.98	$3.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $34.67 / $81.28	Professional		$23.44	$34.67	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.92 / $38.90	Professional	26	$19.50	$26.92	$38.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $4.79 / $43.65	Professional	TC	$3.02	$4.79	$43.65
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $34.67 / $79.43	Professional		$23.99	$34.67	$79.43
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.92 / $38.90	Professional	26	$19.50	$26.92	$38.90
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $3.02 / $4.79 / $43.65	Professional	TC	$3.02	$4.79	$43.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $32.36 / $33.11	Professional		$20.42	$32.36	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $31.62 / $67.61	Professional		$28.84	$31.62	$67.61
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $26.30 / $39.81	Professional	26	$23.44	$26.30	$39.81
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $3.89 / $4.27 / $37.15	Professional	TC	$3.89	$4.27	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $30.90 / $60.26	Professional		$21.38	$30.90	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $21.38 / $37.15	Professional	26	$14.45	$21.38	$37.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $2.82 / $4.27 / $35.48	Professional	TC	$2.82	$4.27	$35.48