Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.28 / $49.06 / $95.78	Facility	26	$27.28	$49.06	$95.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $119.20 / $225.70	Professional		$90.73	$119.20	$225.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $27.28 / $57.83	Professional	26	$23.81	$27.28	$57.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.45 / $91.93 / $183.00	Professional	TC	$66.45	$91.93	$183.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.47 / $112.63 / $194.16	Professional		$87.47	$112.63	$194.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.99 / $33.08 / $57.26	Professional	26	$26.99	$33.08	$57.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.48 / $77.27 / $135.49	Professional	TC	$60.48	$77.27	$135.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.79 / $94.37 / $123.16	Professional		$28.79	$94.37	$123.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $32.15 / $33.84	Facility	26	$32.15	$32.15	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.20 / $138.66 / $265.77	Professional		$98.20	$138.66	$265.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.36 / $36.95 / $61.87	Professional	26	$24.36	$36.95	$61.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.84 / $104.66 / $192.17	Professional	TC	$73.84	$104.66	$192.17
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $32.15 / $33.84	Facility	26	$32.15	$32.15	$33.84
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $95.74 / $139.94 / $250.79	Professional		$95.74	$139.94	$250.79
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $26.17 / $37.04 / $60.19	Professional	26	$26.17	$37.04	$60.19
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $77.18 / $106.27 / $189.15	Professional	TC	$77.18	$106.27	$189.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.51 / $117.26 / $181.19	Professional		$40.51	$117.26	$181.19
United Facility/Professional Professional Modifier Low / Median / High Price $90.83 / $127.25 / $227.93	Professional		$90.83	$127.25	$227.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.48 / $33.35 / $62.35	Professional	26	$24.48	$33.35	$62.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.20 / $100.97 / $180.33	Professional	TC	$66.20	$100.97	$180.33