Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $109.90 / $184.87	Professional		$85.00	$109.90	$184.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.12 / $31.72 / $58.68	Professional	26	$30.12	$31.72	$58.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.88 / $78.18 / $126.19	Professional	TC	$54.88	$78.18	$126.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.50 / $114.16 / $263.32	Professional		$88.50	$114.16	$263.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $31.61 / $79.15	Professional	26	$24.51	$31.61	$79.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.99 / $82.54 / $162.94	Professional	TC	$63.99	$82.54	$162.94
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $108.17 / $108.17 / $108.17	Professional		$108.17	$108.17	$108.17
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $31.25 / $31.25 / $31.25	Professional	26	$31.25	$31.25	$31.25
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $76.92 / $76.92 / $76.92	Professional	TC	$76.92	$76.92	$76.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $134.37 / $246.21	Professional		$65.95	$134.37	$246.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.41 / $40.35 / $80.02	Professional	26	$19.41	$40.35	$80.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.49 / $93.62 / $169.18	Professional	TC	$41.49	$93.62	$169.18
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $134.37 / $268.74	Professional		$65.95	$134.37	$268.74
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $19.41 / $40.76 / $85.54	Professional	26	$19.41	$40.76	$85.54
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $41.49 / $93.62 / $169.21	Professional	TC	$41.49	$93.62	$169.21
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 $80.33 / $125.36 / $231.76	Professional		$80.33	$125.36	$231.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.43 / $42.37 / $78.33	Professional	26	$25.43	$42.37	$78.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.79 / $82.99 / $153.43	Professional	TC	$49.79	$82.99	$153.43