Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $218.78	Professional		$72.44	$107.15	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $18.20 / $39.81	Professional	26	$15.14	$18.20	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $89.13 / $173.78	Professional	TC	$60.26	$89.13	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $77.62 / $144.54	Professional		$56.23	$77.62	$144.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $25.12 / $41.69	Professional	26	$19.95	$25.12	$41.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $50.12 / $112.20	Professional	TC	$34.67	$50.12	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $112.20 / $218.78	Professional		$72.44	$112.20	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $25.12 / $41.69	Professional	26	$16.22	$25.12	$41.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $93.33 / $186.21	Professional	TC	$53.70	$93.33	$186.21
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $107.15 / $213.80	Professional		$69.18	$107.15	$213.80
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $24.55 / $44.67	Professional	26	$16.22	$24.55	$44.67
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $91.20 / $181.97	Professional	TC	$54.95	$91.20	$181.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $131.83 / $245.47	Professional		$109.65	$131.83	$245.47
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.44 / $42.66	Professional	26	$19.05	$23.44	$42.66
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $107.15 / $204.17	Professional	TC	$91.20	$107.15	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $102.33 / $173.78	Professional		$58.88	$102.33	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.42 / $35.48	Professional	26	$15.14	$20.42	$35.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $83.18 / $141.25	Professional	TC	$45.71	$83.18	$141.25