Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.71 / $50.40 / $102.70	Facility	26	$26.71	$50.40	$102.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $86.03 / $155.37	Professional		$74.13	$86.03	$155.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.52 / $58.88 / $104.97	Professional	TC	$49.52	$58.88	$104.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.87 / $94.24 / $173.17	Professional		$62.87	$94.24	$173.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.78 / $59.94 / $109.66	Professional	TC	$33.78	$59.94	$109.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $28.55 / $59.08 / $87.63	Professional		$28.55	$59.08	$87.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $31.62 / $36.35	Facility	26	$31.62	$31.62	$36.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.20 / $117.78 / $220.50	Professional		$78.20	$117.78	$220.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.64 / $79.64 / $150.38	Professional	TC	$52.64	$79.64	$150.38
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $31.62 / $36.35	Facility	26	$31.62	$31.62	$36.35
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $79.51 / $115.48 / $195.08	Professional		$79.51	$115.48	$195.08
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $54.83 / $79.59 / $146.41	Professional	TC	$54.83	$79.59	$146.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.46 / $82.38 / $132.19	Professional		$40.46	$82.38	$132.19
United Facility/Professional Professional Modifier Low / Median / High Price $76.59 / $107.92 / $188.58	Professional		$76.59	$107.92	$188.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.96 / $74.16 / $123.25	Professional	TC	$51.96	$74.16	$123.25