Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.17 / $156.38 / $351.03	Facility	26	$105.17	$156.38	$351.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $350.44 / $350.44 / $827.00	Professional		$350.44	$350.44	$827.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.17 / $105.17 / $245.00	Professional	26	$105.17	$105.17	$245.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.28 / $245.28 / $490.99	Professional	TC	$245.28	$245.28	$490.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $247.41 / $339.69 / $608.41	Professional		$247.41	$339.69	$608.41
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.54 / $121.99 / $225.10	Professional	26	$91.54	$121.99	$225.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $155.87 / $220.06 / $387.15	Professional	TC	$155.87	$220.06	$387.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.10 / $229.58 / $338.68	Professional		$109.10	$229.58	$338.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.14 / $431.52 / $701.09	Professional		$317.14	$431.52	$701.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.74 / $152.79 / $219.17	Professional	26	$103.74	$152.79	$219.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $212.94 / $292.19 / $493.96	Professional	TC	$212.94	$292.19	$493.96
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $317.14 / $445.49 / $696.68	Professional		$317.14	$445.49	$696.68
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $106.32 / $152.79 / $219.17	Professional	26	$106.32	$152.79	$219.17
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $213.41 / $292.19 / $488.16	Professional	TC	$213.41	$292.19	$488.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $104.04 / $257.84 / $448.39	Professional		$104.04	$257.84	$448.39
United Facility/Professional Professional Modifier Low / Median / High Price $290.44 / $393.93 / $728.11	Professional		$290.44	$393.93	$728.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.69 / $137.44 / $234.32	Professional	26	$103.69	$137.44	$234.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.87 / $269.95 / $490.84	Professional	TC	$192.87	$269.95	$490.84