Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.15 / $40.33 / $79.90	Facility	26	$22.15	$40.33	$79.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.88 / $130.49 / $229.73	Professional		$93.88	$130.49	$229.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $108.34 / $189.40	Professional	TC	$78.06	$108.34	$189.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.80 / $114.73 / $200.31	Professional		$80.80	$114.73	$200.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $55.80 / $81.44 / $149.83	Professional	TC	$55.80	$81.44	$149.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.00 / $112.89 / $136.90	Professional		$24.00	$112.89	$136.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $28.50	Facility	26	$26.26	$26.26	$28.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.93 / $153.18 / $286.23	Professional		$100.93	$153.18	$286.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.04 / $123.15 / $229.88	Professional	TC	$84.04	$123.15	$229.88
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $28.50	Facility	26	$26.26	$26.26	$28.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $99.80 / $154.05 / $267.33	Professional		$99.80	$154.05	$267.33
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $88.86 / $123.38 / $217.88	Professional	TC	$88.86	$123.38	$217.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $88.19 / $123.98 / $190.69	Professional		$88.19	$123.98	$190.69
United Facility/Professional Professional Modifier Low / Median / High Price $96.43 / $132.09 / $244.32	Professional		$96.43	$132.09	$244.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.42 / $109.29 / $196.36	Professional	TC	$73.42	$109.29	$196.36