Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $688.93 / $1,615.00 / $13,764.00	Facility		$688.93	$1,615.00	$13,764.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $606.10 / $606.10 / $606.10	Facility		$606.10	$606.10	$606.10
Medcost Facility/Professional Facility Modifier Low / Median / High Price $688.93 / $947.14 / $1,399.05	Facility		$688.93	$947.14	$1,399.05
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $166.59 / $228.80 / $311.39	Facility	80	$166.59	$228.80	$311.39
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $116.61 / $160.16 / $217.98	Facility	AS	$116.61	$160.16	$217.98
United Facility/Professional Facility Modifier Low / Median / High Price $4,015.00 / $15,545.00 / $22,780.00	Facility		$4,015.00	$15,545.00	$22,780.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $11,371.08 / $11,371.08	Facility		$5,000.00	$11,371.08	$11,371.08
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $99.50 / $177.44 / $355.29	Facility	AS	$99.50	$177.44	$355.29