Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.07 / $25.30 / $45.36	Facility	26	$15.07	$25.30	$45.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.59 / $48.17 / $61.72	Professional		$44.59	$48.17	$61.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $15.21 / $19.05	Professional	26	$13.62	$15.21	$19.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.03 / $33.24 / $44.32	Professional	TC	$30.03	$33.24	$44.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.58 / $68.17 / $114.04	Professional		$47.58	$68.17	$114.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.30 / $19.80 / $32.88	Professional	26	$15.30	$19.80	$32.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.08 / $48.38 / $80.73	Professional	TC	$32.08	$48.38	$80.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $14.31 / $30.63 / $52.51	Professional		$14.31	$30.63	$52.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.25 / $16.25 / $16.25	Facility	26	$16.25	$16.25	$16.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.87 / $63.55 / $112.47	Professional		$41.87	$63.55	$112.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.66 / $19.80 / $34.29	Professional	26	$13.66	$19.80	$34.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.17 / $43.74 / $76.01	Professional	TC	$28.17	$43.74	$76.01
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $39.39 / $59.41 / $96.75	Professional		$39.39	$59.41	$96.75
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $13.66 / $18.97 / $29.93	Professional	26	$13.66	$18.97	$29.93
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $26.95 / $41.32 / $68.45	Professional	TC	$26.95	$41.32	$68.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.35 / $33.88 / $49.49	Professional		$25.35	$33.88	$49.49
United Facility/Professional Professional Modifier Low / Median / High Price $42.15 / $59.88 / $101.55	Professional		$42.15	$59.88	$101.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.46 / $18.30 / $32.68	Professional	26	$12.46	$18.30	$32.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.64 / $40.89 / $70.13	Professional	TC	$29.64	$40.89	$70.13