Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.94 / $46.07 / $82.20	Facility	26	$25.94	$46.07	$82.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.30 / $156.50 / $198.64	Professional		$109.30	$156.50	$198.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.29 / $128.97 / $169.43	Professional	TC	$87.29	$128.97	$169.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.92 / $109.09 / $209.58	Professional		$67.92	$109.09	$209.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.39 / $70.04 / $173.99	Professional	TC	$41.39	$70.04	$173.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.73 / $145.72 / $212.87	Professional		$27.73	$145.72	$212.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.71 / $30.71 / $30.71	Facility	26	$30.71	$30.71	$30.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.58 / $192.36 / $331.12	Professional		$100.58	$192.36	$331.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.84 / $164.26 / $296.02	Professional	TC	$78.84	$164.26	$296.02
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $30.71 / $30.71 / $30.71	Facility	26	$30.71	$30.71	$30.71
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $100.58 / $193.79 / $276.95	Professional		$100.58	$193.79	$276.95
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $86.72 / $165.58 / $238.44	Professional	TC	$86.72	$165.58	$238.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $155.26 / $252.23	Professional		$39.86	$155.26	$252.23
United Facility/Professional Professional Modifier Low / Median / High Price $104.52 / $163.44 / $295.97	Professional		$104.52	$163.44	$295.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.92 / $128.12 / $219.77	Professional	TC	$74.92	$128.12	$219.77