Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $984.70 / $4,400.50 / $10,087.00	Facility		$984.70	$4,400.50	$10,087.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $984.70 / $1,257.42 / $2,460.81	Facility		$984.70	$1,257.42	$2,460.81
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $232.20 / $251.48 / $492.16	Facility	80	$232.20	$251.48	$492.16
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $159.85 / $176.04 / $344.51	Facility	AS	$159.85	$176.04	$344.51
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 / $7,488.16 / $9,092.64	Facility		$55.00	$7,488.16	$9,092.64
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $222.32 / $487.93 / $487.93	Facility	AS	$222.32	$487.93	$487.93