Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $331.13	Professional		$93.33	$114.82	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $40.74 / $144.54	Professional	26	$22.91	$40.74	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $85.11 / $281.84	Professional	TC	$51.29	$85.11	$281.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $204.17	Professional		$41.69	$52.48	$204.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $21.38 / $61.66	Professional	26	$16.60	$21.38	$61.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $31.62 / $120.23	Professional	TC	$25.12	$31.62	$120.23
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $257.04	Professional		$91.20	$91.20	$257.04
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $33.11 / $66.07	Professional	26	$33.11	$33.11	$66.07
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $67.61 / $190.55	Professional	TC	$67.61	$67.61	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $117.49 / $234.42	Professional		$33.11	$117.49	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $104.71 / $208.93	Professional		$52.48	$104.71	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $34.67 / $61.66	Professional	26	$16.60	$34.67	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $56.23 / $154.88	Professional	TC	$29.51	$56.23	$154.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $85.11 / $199.53	Professional		$50.12	$85.11	$199.53
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $34.67 / $63.10	Professional	26	$16.60	$34.67	$63.10
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $50.12 / $154.88	Professional	TC	$34.67	$50.12	$154.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $154.88 / $269.15	Professional		$95.50	$154.88	$269.15
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $44.67 / $75.86	Professional	26	$33.88	$44.67	$75.86
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $117.49 / $173.78	Professional	TC	$81.28	$117.49	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $104.71 / $204.17	Professional		$56.23	$104.71	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $36.31 / $56.23	Professional	26	$21.88	$36.31	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $69.18 / $134.90	Professional	TC	$31.62	$69.18	$134.90