Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.52 / $89.17 / $153.91	Professional		$63.52	$89.17	$153.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.85 / $44.45 / $133.62	Professional	26	$32.85	$44.45	$133.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.37 / $65.45 / $163.40	Professional	TC	$55.37	$65.45	$163.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $19.78 / $21.24	Professional	26	$19.78	$19.78	$21.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.59 / $78.16 / $180.17	Professional		$60.59	$78.16	$180.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.33 / $29.02 / $76.27	Professional	26	$22.33	$29.02	$76.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.46 / $50.90 / $115.06	Professional	TC	$39.46	$50.90	$115.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $85.89 / $153.36	Professional		$39.61	$85.89	$153.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.53 / $112.05 / $210.13	Professional		$52.53	$112.05	$210.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $42.73 / $88.79	Professional	26	$19.80	$42.73	$88.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $69.09 / $122.51	Professional	TC	$32.72	$69.09	$122.51
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $52.53 / $114.81 / $210.13	Professional		$52.53	$114.81	$210.13
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $19.80 / $43.57 / $90.68	Professional	26	$19.80	$43.57	$90.68
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $69.09 / $130.91	Professional	TC	$32.72	$69.09	$130.91
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 $72.73 / $121.23 / $206.09	Professional		$72.73	$121.23	$206.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.34 / $45.56 / $82.96	Professional	26	$27.34	$45.56	$82.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.40 / $75.67 / $128.63	Professional	TC	$45.40	$75.67	$128.63