Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $772.06 / $1,781.31 / $10,561.00	Facility		$772.06	$1,781.31	$10,561.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $728.71 / $1,086.50 / $1,613.61	Facility		$728.71	$1,086.50	$1,613.61
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $217.30 / $217.30 / $362.17	Facility	80	$217.30	$217.30	$362.17
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $123.88 / $152.11 / $253.52	Facility	AS	$123.88	$152.11	$253.52
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 / $7,955.75 / $9,569.34	Facility		$55.00	$7,955.75	$9,569.34
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $174.21 / $189.07 / $365.27	Facility	AS	$174.21	$189.07	$365.27