Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $845.21 / $18,303.84 / $18,303.84	Facility		$845.21	$18,303.84	$18,303.84
Medcost Facility/Professional Facility Modifier Low / Median / High Price $845.21 / $1,168.55 / $2,009.87	Facility		$845.21	$1,168.55	$2,009.87
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $233.71 / $233.71 / $419.55	Facility	80	$233.71	$233.71	$419.55
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $136.63 / $163.60 / $293.69	Facility	AS	$136.63	$163.60	$293.69
United Facility/Professional Facility Modifier Low / Median / High Price $1,172.00 / $4,086.00 / $7,778.00	Facility		$1,172.00	$4,086.00	$7,778.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $12,826.56 / $15,515.36	Facility		$55.00	$12,826.56	$15,515.36
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $189.69 / $414.83 / $414.83	Facility	AS	$189.69	$414.83	$414.83