Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $11.48 / $16.22	Facility	26	$8.51	$11.48	$16.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $67.61 / $204.17	Professional		$51.29	$67.61	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.23 / $32.36	Professional	26	$7.94	$10.23	$32.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.13 / $8.32 / $39.81	Professional	52	$8.13	$8.32	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $104.71	Professional	TC	$42.66	$52.48	$104.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $57.54 / $79.43	Professional		$46.77	$57.54	$79.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.55 / $12.59	Professional	26	$7.59	$9.55	$12.59
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $63.10 / $75.86	Professional	TC	$44.67	$63.10	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $97.72	Professional		$46.77	$60.26	$97.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.33 / $14.79	Professional	26	$7.41	$9.33	$14.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $51.29 / $81.28	Professional	TC	$39.81	$51.29	$81.28
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $64.57 / $117.49	Professional		$50.12	$64.57	$117.49
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.72 / $18.62	Professional	26	$8.32	$10.72	$18.62
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $54.95 / $100.00	Professional	TC	$41.69	$54.95	$100.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $51.29 / $95.50	Professional		$9.55	$51.29	$95.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $125.89	Professional		$52.48	$72.44	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.48 / $19.95	Professional	26	$8.51	$11.48	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $60.26 / $109.65	Professional	TC	$43.65	$60.26	$109.65
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $109.65	Professional		$45.71	$67.61	$109.65
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.22 / $19.50	Professional	26	$7.94	$11.22	$19.50
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $58.88 / $91.20	Professional	TC	$42.66	$58.88	$91.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $6.61 / $32.36 / $33.11	Professional		$6.61	$32.36	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $70.79 / $131.83	Professional		$58.88	$70.79	$131.83
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $11.22 / $21.38	Professional	26	$9.55	$11.22	$21.38
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $58.88 / $109.65	Professional	TC	$50.12	$58.88	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $60.26 / $97.72	Professional		$43.65	$60.26	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.55 / $16.60	Professional	26	$7.08	$9.55	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $50.12 / $81.28	Professional	TC	$36.31	$50.12	$81.28