Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $728.16 / $4,839.71 / $19,269.80	Facility		$728.16	$4,839.71	$19,269.80
Medcost Facility/Professional Facility Modifier Low / Median / High Price $728.16 / $1,108.00 / $1,842.46	Facility		$728.16	$1,108.00	$1,842.46
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $186.40 / $221.60 / $368.49	Facility	80	$186.40	$221.60	$368.49
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $118.78 / $155.12 / $257.94	Facility	AS	$118.78	$155.12	$257.94
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 $4,802.00 / $10,160.00 / $13,486.75	Facility		$4,802.00	$10,160.00	$13,486.75
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $169.99 / $1,279.44 / $1,279.44	Facility	AS	$169.99	$1,279.44	$1,279.44