Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $851.49 / $1,346.54 / $7,439.00	Facility		$851.49	$1,346.54	$7,439.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $851.49 / $1,194.16 / $2,076.44	Facility		$851.49	$1,194.16	$2,076.44
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $202.40 / $238.83 / $415.29	Facility	80	$202.40	$238.83	$415.29
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $133.76 / $167.18 / $290.70	Facility	AS	$133.76	$167.18	$290.70
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 / $6,173.84 / $7,644.88	Facility		$55.00	$6,173.84	$7,644.88
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $191.52 / $412.05 / $412.05	Facility	AS	$191.52	$412.05	$412.05