Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,252.02 / $1,948.73 / $10,530.24	Facility		$1,252.02	$1,948.73	$10,530.24
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,252.02 / $1,736.55 / $3,064.30	Facility		$1,252.02	$1,736.55	$3,064.30
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $335.20 / $347.31 / $583.66	Facility	80	$335.20	$347.31	$583.66
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $200.82 / $243.12 / $408.56	Facility	AS	$200.82	$243.12	$408.56
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 / $10,502.82 / $12,628.89	Facility		$55.00	$10,502.82	$12,628.89
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $279.73 / $304.80 / $590.55	Facility	AS	$279.73	$304.80	$590.55