Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.10 / $49.59 / $98.33	Facility	26	$27.10	$49.59	$98.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.50 / $50.14 / $139.41	Professional		$44.50	$50.14	$139.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $28.57 / $59.53	Professional	26	$25.82	$28.57	$59.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.41 / $22.73 / $38.85	Professional	TC	$17.41	$22.73	$38.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.38 / $33.45 / $35.89	Professional		$30.38	$33.45	$35.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $30.30 / $45.74	Professional	26	$21.51	$30.30	$45.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.87 / $59.00 / $105.48	Professional		$51.87	$59.00	$105.48
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.45 / $33.74 / $60.12	Professional	26	$29.45	$33.74	$60.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $24.43 / $45.72	Professional	TC	$20.14	$24.43	$45.72
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $40.74 / $40.74	Professional		$40.74	$40.74	$40.74
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $26.89 / $26.89 / $26.89	Professional	26	$26.89	$26.89	$26.89
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $13.85 / $13.85 / $13.85	Professional	TC	$13.85	$13.85	$13.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.24 / $34.49 / $59.91	Professional		$15.24	$34.49	$59.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $39.28	Professional		$39.28	$39.28	$39.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $25.29	Professional	26	$25.29	$25.29	$25.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $13.99	Professional	TC	$13.99	$13.99	$13.99
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $39.28 / $39.28	Professional		$39.28	$39.28	$39.28
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $25.29 / $25.29 / $57.32	Professional	26	$25.29	$25.29	$57.32
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $13.99 / $13.99 / $13.99	Professional	TC	$13.99	$13.99	$13.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $64.33 / $95.99	Professional		$34.47	$64.33	$95.99
United Facility/Professional Professional Modifier Low / Median / High Price $48.89 / $62.21 / $111.88	Professional		$48.89	$62.21	$111.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.37 / $34.85 / $58.78	Professional	26	$27.37	$34.85	$58.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.11 / $27.32 / $47.99	Professional	TC	$20.11	$27.32	$47.99