Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.53 / $111.02 / $244.64	Professional		$86.53	$111.02	$244.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $32.22 / $74.31	Professional	26	$17.05	$32.22	$74.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.49 / $84.00 / $190.10	Professional	TC	$51.49	$84.00	$190.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $24.61 / $45.95	Professional	26	$16.41	$24.61	$45.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.39 / $53.10 / $209.99	Professional		$41.39	$53.10	$209.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.48 / $21.42 / $65.00	Professional	26	$16.48	$21.42	$65.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.92 / $31.63 / $126.13	Professional	TC	$24.92	$31.63	$126.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.82 / $116.44 / $213.84	Professional		$32.82	$116.44	$213.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.96 / $104.00 / $207.75	Professional		$59.96	$104.00	$207.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $34.33 / $62.39	Professional	26	$16.41	$34.33	$62.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.04 / $57.19 / $155.24	Professional	TC	$35.04	$57.19	$155.24
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $55.75 / $106.68 / $207.75	Professional		$55.75	$106.68	$207.75
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $16.41 / $35.86 / $74.59	Professional	26	$16.41	$35.86	$74.59
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $35.04 / $63.67 / $160.10	Professional	TC	$35.04	$63.67	$160.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.30 / $122.29 / $227.20	Professional		$40.30	$122.29	$227.20
United Facility/Professional Professional Modifier Low / Median / High Price $55.60 / $119.93 / $208.17	Professional		$55.60	$119.93	$208.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.00 / $36.65 / $66.76	Professional	26	$22.00	$36.65	$66.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.32 / $69.09 / $151.63	Professional	TC	$31.32	$69.09	$151.63