Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $128.82	Professional		$39.81	$60.26	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.89 / $63.10	Professional	26	$15.14	$20.89	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $40.74 / $89.13	Professional	TC	$25.12	$40.74	$89.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $33.88 / $114.82	Professional		$26.92	$33.88	$114.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.80 / $41.69	Professional	26	$10.47	$13.80	$41.69
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $20.89 / $67.61	Professional	TC	$16.60	$20.89	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $57.54 / $117.49	Professional		$30.90	$57.54	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $23.44 / $42.66	Professional	26	$11.75	$23.44	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.90 / $83.18	Professional	TC	$18.62	$30.90	$83.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $120.23	Professional		$32.36	$44.67	$120.23
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $20.89 / $41.69	Professional	26	$11.75	$20.89	$41.69
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.92 / $83.18	Professional	TC	$19.50	$26.92	$83.18
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 $79.43 / $95.50 / $162.18	Professional		$79.43	$95.50	$162.18
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.20 / $53.70	Professional	26	$24.55	$30.20	$53.70
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $66.07 / $95.50	Professional	TC	$42.66	$66.07	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $57.54 / $112.20	Professional		$32.36	$57.54	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $25.12 / $38.02	Professional	26	$14.45	$25.12	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $33.88 / $67.61	Professional	TC	$17.78	$33.88	$67.61