Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,589.06 / $11,115.89 / $20,279.06	Facility		$1,589.06	$11,115.89	$20,279.06
Medcost Facility/Professional Facility Modifier Low / Median / High Price $997.74 / $1,520.24 / $2,518.32	Facility		$997.74	$1,520.24	$2,518.32
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $253.01 / $305.60 / $526.32	Facility	80	$253.01	$305.60	$526.32
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $163.03 / $213.92 / $368.40	Facility	AS	$163.03	$213.92	$368.40
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 $6,606.53 / $8,112.30 / $21,000.00	Facility		$6,606.53	$8,112.30	$21,000.00
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $229.84 / $500.32 / $500.32	Facility	AS	$229.84	$500.32	$500.32