Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $787.39 / $1,286.27 / $6,953.60	Facility		$787.39	$1,286.27	$6,953.60
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $393.70 / $443.47 / $643.14	Facility	52	$393.70	$443.47	$643.14
Medcost Facility/Professional Facility Modifier Low / Median / High Price $787.39 / $1,106.59 / $1,997.46	Facility		$787.39	$1,106.59	$1,997.46
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $195.20 / $221.32 / $399.49	Facility	80	$195.20	$221.32	$399.49
United Facility/Professional Facility Modifier Low / Median / High Price $12,077.00 / $26,232.00 / $43,834.00	Facility		$12,077.00	$26,232.00	$43,834.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $5,198.76 / $12,000.00 / $96,288.85	Facility		$5,198.76	$12,000.00	$96,288.85
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $1,476.06 / $73,014.52 / $73,014.52	Facility	52	$1,476.06	$73,014.52	$73,014.52