Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.89 / $329.59 / $7,439.00	Facility		$208.89	$329.59	$7,439.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $104.45 / $147.86 / $170.33	Facility	52	$104.45	$147.86	$170.33
Medcost Facility/Professional Facility Modifier Low / Median / High Price $208.89 / $289.52 / $489.17	Facility		$208.89	$289.52	$489.17
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $56.06 / $57.90 / $102.55	Facility	80	$56.06	$57.90	$102.55
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $33.49 / $40.53 / $71.78	Facility	AS	$33.49	$40.53	$71.78
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 / $509.32 / $983.16	Facility		$55.00	$509.32	$983.16
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $377.21 / $786.53 / $786.53	Facility	52	$377.21	$786.53	$786.53
Wellcare Facility/Professional Facility Modifier 62 Low / Median / High Price $294.69 / $614.48 / $614.48	Facility	62	$294.69	$614.48	$614.48
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $47.15 / $98.32 / $98.32	Facility	AS	$47.15	$98.32	$98.32