Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.23 / $5.40 / $9.51	Facility	26	$3.23	$5.40	$9.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.58 / $38.21 / $135.06	Professional		$23.58	$38.21	$135.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.01 / $4.04 / $14.55	Professional	26	$3.01	$4.04	$14.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.33 / $11.79 / $21.34	Professional	52	$11.33	$11.79	$21.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.35 / $33.75 / $90.00	Professional	TC	$20.35	$33.75	$90.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.67 / $19.98 / $28.34	Professional		$17.67	$19.98	$28.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.27 / $2.91 / $4.42	Professional	26	$2.27	$2.91	$4.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.27 / $87.86 / $147.32	Professional		$26.27	$87.86	$147.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.22 / $4.63 / $7.97	Professional	26	$3.22	$4.63	$7.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.60 / $82.05 / $139.28	Professional	TC	$22.60	$82.05	$139.28
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $26.31 / $26.31 / $26.31	Professional		$26.31	$26.31	$26.31
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $3.71 / $3.71 / $3.71	Professional	26	$3.71	$3.71	$3.71
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $22.61 / $22.61 / $22.61	Professional	TC	$22.61	$22.61	$22.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $3.14 / $20.23 / $28.91	Professional		$3.14	$20.23	$28.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.63 / $35.89 / $118.94	Professional		$22.63	$35.89	$118.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.09 / $4.50 / $7.15	Professional	26	$3.09	$4.50	$7.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $31.35 / $108.14	Professional	TC	$19.54	$31.35	$108.14
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $21.12 / $33.67 / $112.58	Professional		$21.12	$33.67	$112.58
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $3.13 / $4.46 / $7.27	Professional	26	$3.13	$4.46	$7.27
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $28.98 / $79.31	Professional	TC	$19.54	$28.98	$79.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $35.43 / $50.20	Professional		$25.04	$35.43	$50.20
United Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $33.13 / $94.04	Professional		$22.00	$33.13	$94.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.87 / $4.20 / $6.75	Professional	26	$2.87	$4.20	$6.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.09 / $27.84 / $70.91	Professional	TC	$19.09	$27.84	$70.91