Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.05 / $98.34 / $174.26	Facility	26	$54.05	$98.34	$174.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $298.66 / $381.95 / $675.14	Professional		$298.66	$381.95	$675.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.84 / $327.94 / $576.79	Professional	TC	$249.84	$327.94	$576.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.72 / $298.92 / $515.32	Professional		$203.72	$298.92	$515.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $122.37 / $228.40 / $424.16	Professional	TC	$122.37	$228.40	$424.16
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.40 / $351.87 / $465.09	Professional		$57.40	$351.87	$465.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.01 / $472.75 / $930.47	Professional		$296.01	$472.75	$930.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $236.79 / $399.85 / $785.73	Professional	TC	$236.79	$399.85	$785.73
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $269.14 / $459.71 / $718.87	Professional		$269.14	$459.71	$718.87
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $245.50 / $399.85 / $618.00	Professional	TC	$245.50	$399.85	$618.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $62.33 / $337.38 / $533.46	Professional		$62.33	$337.38	$533.46
United Facility/Professional Professional Modifier Low / Median / High Price $279.19 / $436.49 / $784.79	Professional		$279.19	$436.49	$784.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.27 / $368.75 / $652.33	Professional	TC	$218.27	$368.75	$652.33