Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.98 / $81.70 / $185.92	Facility	26	$66.98	$81.70	$185.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.84 / $415.39 / $563.95	Professional		$354.84	$415.39	$563.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.19 / $62.46 / $83.37	Professional	26	$53.19	$62.46	$83.37
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $173.59 / $203.80 / $262.18	Professional	52	$173.59	$203.80	$262.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $299.45 / $349.27 / $480.57	Professional	TC	$299.45	$349.27	$480.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $383.81 / $481.39 / $815.69	Professional		$383.81	$481.39	$815.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.44 / $69.00 / $111.59	Professional	26	$53.44	$69.00	$111.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $329.80 / $410.12 / $702.19	Professional	TC	$329.80	$410.12	$702.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.30 / $347.03 / $462.88	Professional		$60.30	$347.03	$462.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.31 / $67.31 / $67.31	Facility	26	$67.31	$67.31	$67.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $361.32 / $572.70 / $1,016.50	Professional		$361.32	$572.70	$1,016.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $84.97 / $149.53	Professional	26	$54.82	$84.97	$149.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $308.41 / $474.27 / $854.85	Professional	TC	$308.41	$474.27	$854.85
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $67.31 / $67.31 / $67.31	Facility	26	$67.31	$67.31	$67.31
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $358.57 / $547.29 / $823.39	Professional		$358.57	$547.29	$823.39
Medical Mutual of Ohio Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $82.30 / $137.07	Professional	26	$54.82	$82.30	$137.07
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $308.39 / $457.45 / $741.95	Professional	TC	$308.39	$457.45	$741.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.96 / $365.91 / $551.86	Professional		$39.96	$365.91	$551.86
United Facility/Professional Professional Modifier Low / Median / High Price $365.43 / $527.36 / $876.63	Professional		$365.43	$527.36	$876.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.06 / $131.52	Professional	26	$54.95	$81.06	$131.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $311.89 / $446.67 / $734.77	Professional	TC	$311.89	$446.67	$734.77