Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.77 / $132.66 / $312.63	Facility	26	$92.77	$132.66	$312.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $754.91 / $944.35 / $1,658.00	Professional		$754.91	$944.35	$1,658.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.77 / $115.03 / $312.63	Professional	26	$92.77	$115.03	$312.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $662.14 / $849.37 / $1,403.74	Professional	TC	$662.14	$849.37	$1,403.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $749.53 / $929.50 / $1,486.71	Professional		$749.53	$929.50	$1,486.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.29 / $111.61 / $175.83	Professional	26	$87.29	$111.61	$175.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $662.23 / $818.04 / $1,313.54	Professional	TC	$662.23	$818.04	$1,313.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.77 / $686.73 / $999.20	Professional		$99.77	$686.73	$999.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $760.38 / $1,160.75 / $1,978.61	Professional		$760.38	$1,160.75	$1,978.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.23 / $132.09 / $222.67	Professional	26	$95.23	$132.09	$222.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $679.75 / $1,024.50 / $1,761.76	Professional	TC	$679.75	$1,024.50	$1,761.76
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $760.38 / $1,122.57 / $1,882.30	Professional		$760.38	$1,122.57	$1,882.30
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $95.23 / $135.97 / $215.40	Professional	26	$95.23	$135.97	$215.40
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $686.73 / $990.48 / $1,668.11	Professional	TC	$686.73	$990.48	$1,668.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $105.26 / $733.61 / $1,134.33	Professional		$105.26	$733.61	$1,134.33
United Facility/Professional Professional Modifier Low / Median / High Price $714.31 / $955.65 / $1,815.74	Professional		$714.31	$955.65	$1,815.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.25 / $113.45 / $205.33	Professional	26	$82.25	$113.45	$205.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $631.49 / $857.01 / $1,667.64	Professional	TC	$631.49	$857.01	$1,667.64