Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $862.05 / $4,763.00 / $15,291.00	Facility		$862.05	$4,763.00	$15,291.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $862.05 / $1,163.44 / $2,160.16	Facility		$862.05	$1,163.44	$2,160.16
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $207.40 / $232.69 / $432.03	Facility	80	$207.40	$232.69	$432.03
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $140.51 / $162.88 / $302.42	Facility	AS	$140.51	$162.88	$302.42
United Facility/Professional Facility Modifier Low / Median / High Price $5,293.00 / $12,216.00 / $19,066.00	Facility		$5,293.00	$12,216.00	$19,066.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $4,027.75 / $12,623.50 / $26,542.00	Facility		$4,027.75	$12,623.50	$26,542.00
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $196.59 / $1,196.53 / $1,196.53	Facility	AS	$196.59	$1,196.53	$1,196.53