Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.20 / $3,649.92 / $12,247.00	Facility		$288.20	$3,649.92	$12,247.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $246.73 / $394.62 / $522.92	Facility		$246.73	$394.62	$522.92
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $67.70 / $86.24 / $123.38	Facility	80	$67.70	$86.24	$123.38
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $40.18 / $60.37 / $86.36	Facility	AS	$40.18	$60.37	$86.36
United Facility/Professional Facility Modifier Low / Median / High Price $361.00 / $896.00 / $2,229.00	Facility		$361.00	$896.00	$2,229.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $571.29 / $3,930.50 / $26,542.00	Facility		$571.29	$3,930.50	$26,542.00
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $57.13 / $119.91 / $119.91	Facility	AS	$57.13	$119.91	$119.91