Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,063.63 / $6,496.58 / $16,148.14	Facility		$1,063.63	$6,496.58	$16,148.14
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $0.26 / $323.89 / $531.82	Facility	52	$0.26	$323.89	$531.82
Medcost Facility/Professional Facility Modifier Low / Median / High Price $647.79 / $1,077.43 / $1,719.23	Facility		$647.79	$1,077.43	$1,719.23
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $195.20 / $215.49 / $327.71	Facility	80	$195.20	$215.49	$327.71
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $105.81 / $150.84 / $229.40	Facility	AS	$105.81	$150.84	$229.40
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 $4,271.89 / $26,542.00 / $27,770.10	Facility		$4,271.89	$26,542.00	$27,770.10
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $1,206.83 / $21,057.68 / $21,057.68	Facility	52	$1,206.83	$21,057.68	$21,057.68
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $150.85 / $2,632.21 / $2,632.21	Facility	AS	$150.85	$2,632.21	$2,632.21