Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.78 / $16.57 / $42.00	Facility	26	$9.78	$16.57	$42.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.21 / $62.10 / $200.00	Professional		$36.21	$62.10	$200.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $13.69 / $40.11	Professional	26	$9.69	$13.69	$40.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $37.79 / $61.46	Professional	TC	$26.30	$37.79	$61.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.00 / $35.19 / $40.67	Professional		$32.00	$35.19	$40.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $10.94 / $13.31	Professional	26	$8.66	$10.94	$13.31
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.48 / $25.81 / $37.04	Professional	TC	$23.48	$25.81	$37.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $64.48 / $105.36	Professional		$43.67	$64.48	$105.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.41 / $17.37 / $29.30	Professional	26	$11.41	$17.37	$29.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.10 / $45.91 / $78.31	Professional	TC	$32.10	$45.91	$78.31
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $35.19 / $38.71 / $46.10	Professional		$35.19	$38.71	$46.10
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $10.46 / $12.46	Professional	26	$9.51	$10.46	$12.46
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $25.68 / $28.25 / $33.64	Professional	TC	$25.68	$28.25	$33.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $11.40 / $34.09 / $57.95	Professional		$11.40	$34.09	$57.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.13 / $61.13 / $105.72	Professional		$40.13	$61.13	$105.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.44 / $14.91 / $25.81	Professional	26	$10.44	$14.91	$25.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.89 / $44.92 / $80.48	Professional	TC	$28.89	$44.92	$80.48
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $33.43 / $55.56 / $104.79	Professional		$33.43	$55.56	$104.79
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $13.98 / $28.12	Professional	26	$10.19	$13.98	$28.12
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $28.89 / $43.97 / $80.48	Professional	TC	$28.89	$43.97	$80.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $33.75 / $49.20	Professional		$25.04	$33.75	$49.20
United Facility/Professional Professional Modifier Low / Median / High Price $44.00 / $62.08 / $109.67	Professional		$44.00	$62.08	$109.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $14.46 / $24.43	Professional	26	$10.38	$14.46	$24.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.93 / $47.76 / $78.06	Professional	TC	$32.93	$47.76	$78.06