Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,615.00 / $5,850.39 / $12,020.22	Facility		$1,615.00	$5,850.39	$12,020.22
Medcost Facility/Professional Facility Modifier Low / Median / High Price $769.90 / $1,053.53 / $1,829.79	Facility		$769.90	$1,053.53	$1,829.79
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $156.60 / $210.71 / $386.40	Facility	80	$156.60	$210.71	$386.40
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $109.62 / $147.49 / $270.48	Facility	AS	$109.62	$147.49	$270.48
United Facility/Professional Facility Modifier Low / Median / High Price $3,366.00 / $9,541.00 / $14,589.00	Facility		$3,366.00	$9,541.00	$14,589.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $3,601.35 / $12,623.50 / $26,542.00	Facility		$3,601.35	$12,623.50	$26,542.00
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $175.93 / $1,196.53 / $1,196.53	Facility	AS	$175.93	$1,196.53	$1,196.53