Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $229.09 / $416.87	Professional		$204.17	$229.09	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.90 / $104.71	Professional	26	$28.18	$38.90	$104.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $190.55 / $501.19	Professional	TC	$165.96	$190.55	$501.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $389.05	Professional		$141.25	$181.97	$389.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $23.44 / $74.13	Professional	26	$18.62	$23.44	$74.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $147.91 / $354.81	Professional	TC	$123.03	$147.91	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $245.47 / $407.38	Professional		$123.03	$245.47	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $38.02 / $75.86	Professional	26	$19.05	$38.02	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $190.55 / $398.11	Professional	TC	$89.13	$190.55	$398.11
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $190.55 / $446.68	Professional		$114.82	$190.55	$446.68
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $38.02 / $83.18	Professional	26	$19.05	$38.02	$83.18
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $147.91 / $398.11	Professional	TC	$102.33	$147.91	$398.11
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 $257.04 / $302.00 / $575.44	Professional		$257.04	$302.00	$575.44
SummaCare Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $50.12 / $89.13	Professional	26	$40.74	$50.12	$89.13
SummaCare Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $257.04 / $478.63	Professional	TC	$204.17	$257.04	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $263.03 / $524.81	Professional		$128.82	$263.03	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $44.67 / $67.61	Professional	26	$26.92	$44.67	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $213.80 / $436.52	Professional	TC	$112.20	$213.80	$436.52