Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $963.66 / $1,578.51 / $8,413.00	Facility		$963.66	$1,578.51	$8,413.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $963.66 / $1,638.22 / $2,243.84	Facility		$963.66	$1,638.22	$2,243.84
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $300.93 / $358.18 / $453.00	Facility	80	$300.93	$358.18	$453.00
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $154.51 / $250.73 / $317.10	Facility	AS	$154.51	$250.73	$317.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,172.00 / $4,086.00 / $7,895.00	Facility		$1,172.00	$4,086.00	$7,895.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $8,092.17 / $9,720.62	Facility		$55.00	$8,092.17	$9,720.62
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $214.15 / $234.28 / $455.59	Facility	AS	$214.15	$234.28	$455.59