Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $865.77 / $4,148.00 / $7,439.00	Facility		$865.77	$4,148.00	$7,439.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $865.77 / $1,082.45 / $1,439.00	Facility		$865.77	$1,082.45	$1,439.00
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $168.03 / $217.20 / $254.75	Facility	80	$168.03	$217.20	$254.75
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $117.62 / $152.04 / $168.56	Facility	AS	$117.62	$152.04	$168.56
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 $5,710.74 / $7,152.74 / $16,394.00	Facility		$5,710.74	$7,152.74	$16,394.00
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $207.29 / $232.89 / $652.85	Facility	AS	$207.29	$232.89	$652.85