Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.90 / $903.00 / $7,362.00	Facility		$119.90	$903.00	$7,362.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $112.95 / $174.97 / $250.59	Facility		$112.95	$174.97	$250.59
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $262.45 / $262.45 / $419.23	Facility	50	$262.45	$262.45	$419.23
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $34.99 / $34.99 / $55.90	Facility	80	$34.99	$34.99	$55.90
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $19.20 / $24.50 / $39.13	Facility	AS	$19.20	$24.50	$39.13
United Facility/Professional Facility Modifier Low / Median / High Price $361.00 / $896.00 / $2,229.00	Facility		$361.00	$896.00	$2,229.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $271.99 / $555.55	Facility		$55.00	$271.99	$555.55
Wellcare Facility/Professional Facility Modifier 62 Low / Median / High Price $169.99 / $181.13 / $347.22	Facility	62	$169.99	$181.13	$347.22
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $27.20 / $28.98 / $55.56	Facility	AS	$27.20	$28.98	$55.56