Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.42 / $40.58 / $86.68	Facility	26	$26.42	$40.58	$86.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $64.34 / $111.61	Professional		$56.32	$64.34	$111.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.14 / $29.30 / $48.60	Professional	26	$25.14	$29.30	$48.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $34.52 / $56.30	Professional	TC	$29.51	$34.52	$56.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.43 / $52.43 / $52.43	Professional		$52.43	$52.43	$52.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.42 / $30.82 / $39.79	Professional	26	$24.42	$30.82	$39.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.78 / $74.63 / $120.57	Professional		$51.78	$74.63	$120.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.66 / $32.92 / $51.36	Professional	26	$25.66	$32.92	$51.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.12 / $40.28 / $70.93	Professional	TC	$26.12	$40.28	$70.93
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $63.66 / $63.66 / $63.66	Professional		$63.66	$63.66	$63.66
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $28.25 / $28.25	Professional	26	$28.25	$28.25	$28.25
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $35.42 / $35.42 / $35.42	Professional	TC	$35.42	$35.42	$35.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.25 / $37.54 / $75.06	Professional		$28.25	$37.54	$75.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.56 / $79.56 / $151.66	Professional		$56.56	$79.56	$151.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.08 / $35.95 / $54.94	Professional	26	$26.08	$35.95	$54.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.16 / $42.43 / $77.00	Professional	TC	$28.16	$42.43	$77.00
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $52.56 / $79.75 / $134.79	Professional		$52.56	$79.75	$134.79
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $26.08 / $36.99 / $57.00	Professional	26	$26.08	$36.99	$57.00
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $28.16 / $42.66 / $65.45	Professional	TC	$28.16	$42.66	$65.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $46.80 / $84.47	Professional		$28.10	$46.80	$84.47
United Facility/Professional Professional Modifier Low / Median / High Price $47.76 / $65.13 / $115.78	Professional		$47.76	$65.13	$115.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.39 / $31.28 / $56.07	Professional	26	$23.39	$31.28	$56.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.74 / $33.10 / $54.60	Professional	TC	$24.74	$33.10	$54.60