Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.73 / $21.33 / $38.00	Facility	26	$11.73	$21.33	$38.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.74 / $41.18 / $66.90	Professional		$35.74	$41.18	$66.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.99 / $12.13 / $17.36	Professional	26	$10.99	$12.13	$17.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.81 / $29.46 / $40.29	Professional	TC	$24.81	$29.46	$40.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.81 / $45.78 / $70.97	Professional		$35.81	$45.78	$70.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.39 / $13.20 / $20.36	Professional	26	$10.39	$13.20	$20.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.41 / $32.51 / $50.41	Professional	TC	$25.41	$32.51	$50.41
CareSource Facility/Professional Professional Modifier Low / Median / High Price $12.54 / $31.48 / $50.03	Professional		$12.54	$31.48	$50.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $13.91 / $13.91	Facility	26	$13.91	$13.91	$13.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.47 / $54.03 / $83.91	Professional		$38.47	$54.03	$83.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.59 / $15.95 / $25.23	Professional	26	$11.59	$15.95	$25.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.87 / $37.47 / $58.68	Professional	TC	$25.87	$37.47	$58.68
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $13.91 / $13.91	Facility	26	$13.91	$13.91	$13.91
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $38.47 / $55.23 / $81.47	Professional		$38.47	$55.23	$81.47
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $11.51 / $16.09 / $24.68	Professional	26	$11.51	$16.09	$24.68
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $25.87 / $38.29 / $56.79	Professional	TC	$25.87	$38.29	$56.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.35 / $33.83 / $49.47	Professional		$25.35	$33.83	$49.47
United Facility/Professional Professional Modifier Low / Median / High Price $33.20 / $44.87 / $77.04	Professional		$33.20	$44.87	$77.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.39 / $13.96 / $24.32	Professional	26	$10.39	$13.96	$24.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.49 / $31.22 / $51.81	Professional	TC	$22.49	$31.22	$51.81