Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $53.70 / $91.20	Professional		$47.86	$53.70	$91.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $19.05 / $33.88	Professional	26	$16.98	$19.05	$33.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $33.88 / $56.23	Professional	TC	$30.90	$33.88	$56.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $97.72	Professional		$32.36	$40.74	$97.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.79 / $37.15	Professional	26	$11.48	$14.79	$37.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $26.30 / $61.66	Professional	TC	$20.42	$26.30	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $60.26 / $107.15	Professional		$30.20	$60.26	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $22.91 / $38.90	Professional	26	$11.48	$22.91	$38.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $35.48 / $70.79	Professional	TC	$18.20	$35.48	$70.79
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $51.29 / $102.33	Professional		$30.20	$51.29	$102.33
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $20.42 / $44.67	Professional	26	$11.48	$20.42	$44.67
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $34.67 / $70.79	Professional	TC	$18.20	$34.67	$70.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $77.62 / $138.04	Professional		$63.10	$77.62	$138.04
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.20 / $53.70	Professional	26	$24.55	$30.20	$53.70
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $50.12 / $85.11	Professional	TC	$38.02	$50.12	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $61.66 / $112.20	Professional		$36.31	$61.66	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $22.39 / $40.74	Professional	26	$13.18	$22.39	$40.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $38.90 / $69.18	Professional	TC	$23.44	$38.90	$69.18