Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.07 / $84.38 / $258.00	Professional		$83.07	$84.38	$258.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.05 / $26.66 / $71.55	Professional	26	$25.05	$26.66	$71.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.01 / $58.37 / $202.44	Professional	TC	$58.01	$58.37	$202.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.65 / $128.15 / $261.00	Professional		$105.65	$128.15	$261.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $31.08 / $76.17	Professional	26	$24.10	$31.08	$76.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.56 / $94.60 / $187.99	Professional	TC	$81.56	$94.60	$187.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.29 / $108.44 / $234.95	Professional		$49.29	$108.44	$234.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $32.97 / $72.41	Professional	26	$15.21	$32.97	$72.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.07 / $74.95 / $160.44	Professional	TC	$34.07	$74.95	$160.44
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $49.29 / $112.37 / $246.92	Professional		$49.29	$112.37	$246.92
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $33.47 / $69.83	Professional	26	$15.21	$33.47	$69.83
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $34.07 / $77.44 / $157.69	Professional	TC	$34.07	$77.44	$157.69
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 $64.61 / $107.68 / $219.34	Professional		$64.61	$107.68	$219.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.99 / $34.97 / $64.67	Professional	26	$20.99	$34.97	$64.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.62 / $72.70 / $150.86	Professional	TC	$43.62	$72.70	$150.86