Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.40 / $68.81 / $134.41	Facility	26	$38.40	$68.81	$134.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.87 / $101.82 / $180.35	Professional		$79.87	$101.82	$180.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.52 / $63.42 / $115.80	Professional	TC	$49.52	$63.42	$115.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.28 / $143.86 / $279.60	Professional		$122.28	$143.86	$279.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $75.56 / $99.71 / $205.45	Professional	TC	$75.56	$99.71	$205.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.37 / $66.50 / $107.87	Professional		$41.37	$66.50	$107.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.47 / $45.47 / $47.94	Facility	26	$45.47	$45.47	$47.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.84 / $149.38 / $283.64	Professional		$89.84	$149.38	$283.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.63 / $94.26 / $192.47	Professional	TC	$54.63	$94.26	$192.47
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $45.47 / $45.47 / $47.94	Facility	26	$45.47	$45.47	$47.94
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $90.71 / $144.02 / $291.97	Professional		$90.71	$144.02	$291.97
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $56.00 / $90.28 / $174.50	Professional	TC	$56.00	$90.28	$174.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.43 / $81.89 / $131.17	Professional		$40.43	$81.89	$131.17
United Facility/Professional Professional Modifier Low / Median / High Price $90.71 / $121.62 / $209.32	Professional		$90.71	$121.62	$209.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.57 / $77.01 / $143.26	Professional	TC	$52.57	$77.01	$143.26