Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.31 / $123.88 / $282.30	Facility	26	$83.31	$123.88	$282.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $287.35 / $319.01 / $584.37	Professional		$287.35	$319.01	$584.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.31 / $87.67 / $169.81	Professional	26	$83.31	$87.67	$169.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.05 / $223.45 / $414.57	Professional	TC	$204.05	$223.45	$414.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.98 / $322.06 / $642.66	Professional		$235.98	$322.06	$642.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.86 / $95.74 / $172.78	Professional	26	$70.86	$95.74	$172.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.14 / $244.31 / $457.07	Professional	TC	$165.14	$244.31	$457.07
CareSource Facility/Professional Professional Modifier Low / Median / High Price $87.14 / $188.74 / $275.88	Professional		$87.14	$188.74	$275.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.85 / $385.36 / $601.97	Professional		$263.85	$385.36	$601.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.81 / $122.83 / $172.40	Professional	26	$81.81	$122.83	$172.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $182.04 / $268.77 / $426.61	Professional	TC	$182.04	$268.77	$426.61
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $263.20 / $385.36 / $601.97	Professional		$263.20	$385.36	$601.97
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $87.15 / $122.83 / $169.71	Professional	26	$87.15	$122.83	$169.71
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $187.63 / $273.93 / $423.84	Professional	TC	$187.63	$273.93	$423.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.04 / $219.03 / $365.83	Professional		$104.04	$219.03	$365.83
United Facility/Professional Professional Modifier Low / Median / High Price $269.12 / $371.28 / $650.13	Professional		$269.12	$371.28	$650.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.85 / $109.63 / $187.83	Professional	26	$82.85	$109.63	$187.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $182.35 / $260.33 / $418.69	Professional	TC	$182.35	$260.33	$418.69