Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.04 / $73.16 / $138.59	Facility	26	$43.04	$73.16	$138.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.19 / $341.84 / $584.91	Professional		$282.19	$341.84	$584.91
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $135.47 / $171.80 / $210.14	Professional	52	$135.47	$171.80	$210.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.40 / $297.80 / $450.21	Professional	TC	$247.40	$297.80	$450.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.99 / $353.12 / $548.71	Professional		$250.99	$353.12	$548.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $214.02 / $299.41 / $476.83	Professional	TC	$214.02	$299.41	$476.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $49.44 / $350.88 / $464.73	Professional		$49.44	$350.88	$464.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.88 / $50.88 / $50.88	Facility	26	$50.88	$50.88	$50.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $261.12 / $431.55 / $766.37	Professional		$261.12	$431.55	$766.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.12 / $400.37 / $765.83	Professional	TC	$263.12	$400.37	$765.83
Medical Mutual of Ohio Facility/Professional Facility Modifier 26 Low / Median / High Price $50.88 / $50.88 / $50.88	Facility	26	$50.88	$50.88	$50.88
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $289.85 / $449.12 / $661.95	Professional		$289.85	$449.12	$661.95
Medical Mutual of Ohio Facility/Professional Professional Modifier TC Low / Median / High Price $263.12 / $392.53 / $569.75	Professional	TC	$263.12	$392.53	$569.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $332.24 / $502.79	Professional		$38.81	$332.24	$502.79
United Facility/Professional Professional Modifier Low / Median / High Price $277.08 / $419.24 / $698.61	Professional		$277.08	$419.24	$698.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.22 / $371.46 / $600.04	Professional	TC	$242.22	$371.46	$600.04