Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $946.13 / $1,615.00 / $12,615.00	Facility		$946.13	$1,615.00	$12,615.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $946.13 / $1,341.35 / $2,459.25	Facility		$946.13	$1,341.35	$2,459.25
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $1,905.00 / $2,012.03 / $3,363.00	Facility	50	$1,905.00	$2,012.03	$3,363.00
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $254.00 / $268.27 / $448.40	Facility	80	$254.00	$268.27	$448.40
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $152.06 / $187.79 / $313.88	Facility	AS	$152.06	$187.79	$313.88
United Facility/Professional Facility Modifier Low / Median / High Price $6,688.00 / $15,545.00 / $22,780.00	Facility		$6,688.00	$15,545.00	$22,780.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $7,977.87 / $9,582.29	Facility		$55.00	$7,977.87	$9,582.29
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $213.56 / $231.00 / $446.02	Facility	AS	$213.56	$231.00	$446.02