Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,615.00 / $4,701.72 / $26,589.75	Facility		$1,615.00	$4,701.72	$26,589.75
Medcost Facility/Professional Facility Modifier Low / Median / High Price $3,055.56 / $4,192.22 / $7,559.11	Facility		$3,055.56	$4,192.22	$7,559.11
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $826.40 / $838.44 / $1,500.71	Facility	80	$826.40	$838.44	$1,500.71
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $491.26 / $586.91 / $1,050.50	Facility	AS	$491.26	$586.91	$1,050.50
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 / $60,142.95 / $72,435.30	Facility		$55.00	$60,142.95	$72,435.30
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $689.63 / $750.85 / $1,451.38	Facility	AS	$689.63	$750.85	$1,451.38