Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.42 / $100.35 / $180.12	Facility	26	$56.42	$100.35	$180.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.32 / $158.22 / $296.56	Professional		$153.32	$158.22	$296.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $57.81 / $101.20	Professional	26	$53.70	$57.81	$101.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.29 / $102.06 / $191.32	Professional	TC	$96.29	$102.06	$191.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.83 / $180.23 / $312.30	Professional		$128.83	$180.23	$312.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.36 / $65.16 / $113.08	Professional	26	$49.36	$65.16	$113.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.45 / $111.54 / $213.48	Professional	TC	$79.45	$111.54	$213.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $59.94 / $228.37 / $288.31	Professional		$59.94	$228.37	$288.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.08 / $380.04 / $582.51	Professional		$267.08	$380.04	$582.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.10 / $76.28 / $114.42	Professional	26	$55.10	$76.28	$114.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $206.42 / $302.30 / $476.58	Professional	TC	$206.42	$302.30	$476.58
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $262.10 / $380.04 / $575.00	Professional		$262.10	$380.04	$575.00
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $56.44 / $77.09 / $112.79	Professional	26	$56.44	$77.09	$112.79
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $217.99 / $310.69 / $469.05	Professional	TC	$217.99	$310.69	$469.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.16 / $110.50 / $210.28	Professional		$65.16	$110.50	$210.28
United Facility/Professional Professional Modifier Low / Median / High Price $246.40 / $353.93 / $669.60	Professional		$246.40	$353.93	$669.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.54 / $73.56 / $128.07	Professional	26	$50.54	$73.56	$128.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.10 / $302.63 / $497.59	Professional	TC	$204.10	$302.63	$497.59