Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.42 / $17.12 / $30.33	Facility	26	$11.42	$17.12	$30.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.43 / $58.97 / $152.69	Professional		$49.43	$58.97	$152.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $12.97 / $48.08	Professional	26	$11.08	$12.97	$48.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.04 / $25.92 / $37.61	Professional	52	$23.04	$25.92	$37.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.86 / $43.66 / $69.30	Professional	TC	$36.86	$43.66	$69.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.38 / $51.38 / $59.24	Professional		$46.38	$51.38	$59.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $13.10 / $15.54	Professional	26	$10.10	$13.10	$15.54
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.48 / $57.48 / $57.48	Professional	TC	$57.48	$57.48	$57.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.63 / $58.62 / $90.52	Professional		$45.63	$58.62	$90.52
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.39 / $13.19 / $20.30	Professional	26	$10.39	$13.19	$20.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.24 / $45.60 / $69.90	Professional	TC	$35.24	$45.60	$69.90
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $50.96 / $56.06 / $66.76	Professional		$50.96	$56.06	$66.76
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $11.10 / $12.21 / $14.54	Professional	26	$11.10	$12.21	$14.54
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $39.86 / $43.85 / $52.22	Professional	TC	$39.86	$43.85	$52.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.14 / $50.96 / $83.92	Professional		$13.14	$50.96	$83.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $70.14 / $106.62	Professional		$50.25	$70.14	$106.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.29 / $15.54 / $25.23	Professional	26	$11.29	$15.54	$25.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.97 / $53.76 / $82.59	Professional	TC	$37.97	$53.76	$82.59
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $45.17 / $68.95 / $103.55	Professional		$45.17	$68.95	$103.55
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $11.66 / $15.83 / $28.87	Professional	26	$11.66	$15.83	$28.87
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $37.97 / $54.03 / $80.25	Professional	TC	$37.97	$54.03	$80.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.04 / $33.13 / $49.20	Professional		$25.04	$33.13	$49.20
United Facility/Professional Professional Modifier Low / Median / High Price $43.60 / $59.95 / $104.52	Professional		$43.60	$59.95	$104.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $13.89 / $25.16	Professional	26	$10.10	$13.89	$25.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.50 / $44.63 / $74.95	Professional	TC	$33.50	$44.63	$74.95