Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.90 / $81.59 / $144.44	Facility	26	$43.90	$81.59	$144.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.26 / $96.74 / $118.60	Professional		$79.26	$96.74	$118.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.58 / $50.51 / $60.93	Professional	TC	$40.58	$50.51	$60.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.95 / $87.72 / $145.32	Professional		$59.95	$87.72	$145.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.14 / $21.37 / $58.56	Professional	TC	$13.14	$21.37	$58.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.88 / $48.73 / $101.73	Professional		$42.88	$48.73	$101.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.06 / $52.06 / $52.06	Facility	26	$52.06	$52.06	$52.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.83 / $119.64 / $244.87	Professional		$81.83	$119.64	$244.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.86 / $54.57 / $121.55	Professional	TC	$35.86	$54.57	$121.55
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $52.06 / $52.06 / $52.06	Facility	26	$52.06	$52.06	$52.06
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $80.39 / $113.94 / $179.33	Professional		$80.39	$113.94	$179.33
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $37.33 / $55.14 / $95.39	Professional	TC	$37.33	$55.14	$95.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.36 / $46.80 / $125.10	Professional		$28.36	$46.80	$125.10
United Facility/Professional Professional Modifier Low / Median / High Price $79.34 / $113.10 / $202.36	Professional		$79.34	$113.10	$202.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.38 / $59.08 / $98.94	Professional	TC	$37.38	$59.08	$98.94