Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.49 / $12.14 / $22.00	Facility	26	$8.49	$12.14	$22.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.93 / $59.21 / $156.05	Professional		$51.93	$59.21	$156.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.35 / $27.48	Professional	26	$7.66	$9.35	$27.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.75 / $27.45 / $39.04	Professional	52	$23.75	$27.45	$39.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.99 / $49.36 / $80.84	Professional	TC	$42.99	$49.36	$80.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.62 / $50.13 / $58.78	Professional		$45.62	$50.13	$58.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $9.74 / $11.55	Professional	26	$7.51	$9.74	$11.55
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $38.40 / $42.21 / $60.44	Professional	TC	$38.40	$42.21	$60.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.34 / $58.54 / $89.94	Professional		$45.34	$58.54	$89.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.93 / $9.01 / $13.84	Professional	26	$6.93	$9.01	$13.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.40 / $49.57 / $76.19	Professional	TC	$38.40	$49.57	$76.19
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $50.13 / $57.65 / $91.74	Professional		$50.13	$57.65	$91.74
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.25 / $9.49 / $15.10	Professional	26	$8.25	$9.49	$15.10
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $41.88 / $48.16 / $76.64	Professional	TC	$41.88	$48.16	$76.64
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.71 / $52.35 / $82.84	Professional		$9.71	$52.35	$82.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.13 / $70.18 / $106.62	Professional		$51.13	$70.18	$106.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.33 / $11.30 / $17.64	Professional	26	$8.33	$11.30	$17.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.62 / $58.64 / $89.57	Professional	TC	$42.62	$58.64	$89.57
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $45.21 / $68.38 / $105.46	Professional		$45.21	$68.38	$105.46
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $11.55 / $21.45	Professional	26	$8.36	$11.55	$21.45
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $42.05 / $59.53 / $88.68	Professional	TC	$42.05	$59.53	$88.68
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 $43.51 / $60.03 / $106.15	Professional		$43.51	$60.03	$106.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.03 / $18.30	Professional	26	$7.33	$10.03	$18.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.54 / $50.70 / $84.40	Professional	TC	$36.54	$50.70	$84.40