Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.75 / $95.12 / $159.16	Professional		$57.75	$95.12	$159.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $25.22 / $45.92	Professional	26	$18.30	$25.22	$45.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.45 / $69.90 / $113.23	Professional	TC	$39.45	$69.90	$113.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.64 / $57.58 / $142.30	Professional		$44.64	$57.58	$142.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.54 / $17.46 / $43.84	Professional	26	$13.54	$17.46	$43.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.10 / $40.11 / $102.36	Professional	TC	$31.10	$40.11	$102.36
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $94.68 / $94.68 / $94.68	Professional		$94.68	$94.68	$94.68
Aultcare Facility/Professional Professional Modifier 26 Low / Median / High Price $25.14 / $25.14 / $25.14	Professional	26	$25.14	$25.14	$25.14
Aultcare Facility/Professional Professional Modifier TC Low / Median / High Price $69.54 / $69.54 / $69.54	Professional	TC	$69.54	$69.54	$69.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $90.23 / $188.17	Professional		$53.89	$90.23	$188.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.61 / $30.88 / $51.53	Professional	26	$15.61	$30.88	$51.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.40 / $55.86 / $134.00	Professional	TC	$36.40	$55.86	$134.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $50.81 / $91.54 / $194.05	Professional		$50.81	$91.54	$194.05
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $15.61 / $31.23 / $54.28	Professional	26	$15.61	$31.23	$54.28
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $34.44 / $60.15 / $138.21	Professional	TC	$34.44	$60.15	$138.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.30 / $115.11 / $187.90	Professional		$40.30	$115.11	$187.90
United Facility/Professional Professional Modifier Low / Median / High Price $65.34 / $107.87 / $198.33	Professional		$65.34	$107.87	$198.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.73 / $33.24 / $60.53	Professional	26	$18.73	$33.24	$60.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.14 / $70.36 / $139.90	Professional	TC	$32.14	$70.36	$139.90