Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.96 / $20.75 / $40.51	Facility	26	$11.96	$20.75	$40.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.76 / $96.07 / $171.00	Professional		$75.76	$96.07	$171.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.29 / $12.18 / $25.36	Professional	26	$11.29	$12.18	$25.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.46 / $84.10 / $133.47	Professional	TC	$63.46	$84.10	$133.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.88 / $92.03 / $154.84	Professional		$69.88	$92.03	$154.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.49 / $14.65 / $27.09	Professional	26	$12.49	$14.65	$27.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.71 / $76.16 / $129.13	Professional	TC	$56.71	$76.16	$129.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.18 / $85.94 / $98.12	Professional		$12.18	$85.94	$98.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.12 / $13.50 / $13.50	Facility	26	$12.12	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.66 / $148.83 / $270.01	Professional		$93.66	$148.83	$270.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.27 / $15.68 / $26.61	Professional	26	$10.27	$15.68	$26.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.04 / $132.65 / $247.15	Professional	TC	$82.04	$132.65	$247.15
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $12.12 / $12.12 / $13.50	Facility	26	$12.12	$12.12	$13.50
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $94.90 / $148.83 / $280.58	Professional		$94.90	$148.83	$280.58
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $15.92 / $26.47	Professional	26	$11.22	$15.92	$26.47
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $85.94 / $130.13 / $232.73	Professional	TC	$85.94	$130.13	$232.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $76.59 / $106.37 / $152.18	Professional		$76.59	$106.37	$152.18
United Facility/Professional Professional Modifier Low / Median / High Price $100.72 / $129.63 / $237.74	Professional		$100.72	$129.63	$237.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.98 / $13.98 / $25.26	Professional	26	$9.98	$13.98	$25.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.02 / $114.65 / $219.15	Professional	TC	$89.02	$114.65	$219.15