Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.82 / $11.85 / $25.33	Facility	26	$7.82	$11.85	$25.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.16 / $36.90 / $147.00	Professional		$25.16	$36.90	$147.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $47.07 / $47.07 / $67.50	Professional	25	$47.07	$47.07	$67.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.88 / $22.12	Professional	26	$7.59	$8.88	$22.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $22.85 / $36.13	Professional	TC	$17.32	$22.85	$36.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.13 / $24.94 / $34.61	Professional		$19.13	$24.94	$34.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.38 / $10.64	Professional	26	$6.92	$9.38	$10.64
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.16 / $17.16 / $17.16	Professional	TC	$17.16	$17.16	$17.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.66 / $34.68 / $54.47	Professional		$26.66	$34.68	$54.47
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.44 / $10.27 / $17.07	Professional	26	$7.44	$10.27	$17.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.66 / $25.01 / $40.04	Professional	TC	$17.66	$25.01	$40.04
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $24.73 / $28.44 / $45.26	Professional		$24.73	$28.44	$45.26
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $7.60 / $8.74 / $13.91	Professional	26	$7.60	$8.74	$13.91
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $17.13 / $19.70 / $31.35	Professional	TC	$17.13	$19.70	$31.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $8.94 / $23.13 / $39.72	Professional		$8.94	$23.13	$39.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.27 / $38.33 / $63.65	Professional		$28.27	$38.33	$63.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.68 / $10.64 / $15.96	Professional	26	$7.68	$10.64	$15.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $28.22 / $46.72	Professional	TC	$19.32	$28.22	$46.72
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $25.50 / $37.44 / $62.45	Professional		$25.50	$37.44	$62.45
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.65 / $11.04 / $19.77	Professional	26	$7.65	$11.04	$19.77
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $27.01 / $46.72	Professional	TC	$19.32	$27.01	$46.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $33.75 / $49.42	Professional		$25.04	$33.75	$49.42
United Facility/Professional Professional Modifier Low / Median / High Price $26.98 / $37.40 / $67.66	Professional		$26.98	$37.40	$67.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.75 / $9.52 / $16.88	Professional	26	$6.75	$9.52	$16.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.02 / $28.34 / $48.44	Professional	TC	$20.02	$28.34	$48.44