Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.58 / $186.91 / $578.76	Professional		$67.58	$186.91	$578.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.13 / $26.25 / $97.33	Professional	26	$21.13	$26.25	$97.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.56 / $62.62 / $169.08	Professional	TC	$35.56	$62.62	$169.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.25 / $19.87 / $37.09	Professional	26	$13.25	$19.87	$37.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $38.08 / $129.11	Professional		$29.52	$38.08	$129.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.10 / $15.60 / $44.45	Professional	26	$12.10	$15.60	$44.45
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.48 / $22.54 / $91.02	Professional	TC	$17.48	$22.54	$91.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.49 / $87.38 / $163.57	Professional		$26.49	$87.38	$163.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.47 / $88.47 / $158.90	Professional		$37.47	$88.47	$158.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.25 / $26.49 / $48.50	Professional	26	$13.25	$26.49	$48.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.96 / $50.16 / $112.88	Professional	TC	$22.96	$50.16	$112.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $89.80 / $163.87	Professional		$36.43	$89.80	$163.87
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $13.25 / $28.95 / $54.20	Professional	26	$13.25	$28.95	$54.20
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $21.59 / $53.95 / $116.52	Professional	TC	$21.59	$53.95	$116.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $83.90 / $179.83	Professional		$35.74	$83.90	$179.83
United Facility/Professional Professional Modifier Low / Median / High Price $43.87 / $88.09 / $158.31	Professional		$43.87	$88.09	$158.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.76 / $29.60 / $45.48	Professional	26	$17.76	$29.60	$45.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.93 / $58.10 / $108.14	Professional	TC	$25.93	$58.10	$108.14