Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.82 / $121.67 / $167.25	Professional		$96.82	$121.67	$167.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.08 / $14.45 / $20.73	Professional	26	$13.08	$14.45	$20.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.23 / $106.50 / $148.33	Professional	TC	$84.23	$106.50	$148.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.48 / $81.88 / $176.59	Professional		$41.48	$81.88	$176.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $16.47 / $30.03	Professional	26	$13.14	$16.47	$30.03
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.97 / $58.00 / $137.02	Professional	TC	$24.97	$58.00	$137.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $15.22 / $114.19 / $152.94	Professional		$15.22	$114.19	$152.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.30 / $133.46 / $227.19	Professional		$89.30	$133.46	$227.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.87 / $16.97 / $28.58	Professional	26	$12.87	$16.97	$28.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.43 / $114.19 / $192.75	Professional	TC	$76.43	$114.19	$192.75
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $89.30 / $133.40 / $227.20	Professional		$89.30	$133.40	$227.20
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $12.87 / $16.97 / $30.55	Professional	26	$12.87	$16.97	$30.55
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $76.43 / $116.53 / $194.45	Professional	TC	$76.43	$116.53	$194.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $100.19 / $144.99 / $210.49	Professional		$100.19	$144.99	$210.49
United Facility/Professional Professional Modifier Low / Median / High Price $67.67 / $96.65 / $185.42	Professional		$67.67	$96.65	$185.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.57 / $13.97 / $26.00	Professional	26	$10.57	$13.97	$26.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.96 / $83.26 / $152.25	Professional	TC	$54.96	$83.26	$152.25