Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $257.04	Professional		$70.79	$91.20	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $26.92 / $54.95	Professional	26	$21.88	$26.92	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $64.57 / $204.17	Professional	TC	$48.98	$64.57	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $257.04	Professional		$104.71	$123.03	$257.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $30.90 / $75.86	Professional	26	$23.99	$30.90	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $89.13 / $186.21	Professional	TC	$81.28	$89.13	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $107.15 / $234.42	Professional		$48.98	$107.15	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $33.11 / $72.44	Professional	26	$15.14	$33.11	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $74.13 / $162.18	Professional	TC	$33.88	$74.13	$162.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $109.65 / $245.47	Professional		$48.98	$109.65	$245.47
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $33.11 / $72.44	Professional	26	$15.14	$33.11	$72.44
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $74.13 / $162.18	Professional	TC	$33.88	$74.13	$162.18
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 $102.33 / $134.90 / $346.74	Professional		$102.33	$134.90	$346.74
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $41.69 / $93.33	Professional	26	$31.62	$41.69	$93.33
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $93.33 / $257.04	Professional	TC	$70.79	$93.33	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $109.65 / $213.80	Professional		$64.57	$109.65	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $35.48 / $63.10	Professional	26	$20.89	$35.48	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $74.13 / $151.36	Professional	TC	$43.65	$74.13	$151.36