Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $783.92 / $3,882.98 / $8,442.00	Facility		$783.92	$3,882.98	$8,442.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,645.43 / $3,645.43 / $3,645.43	Facility	50	$3,645.43	$3,645.43	$3,645.43
Medcost Facility/Professional Facility Modifier Low / Median / High Price $783.92 / $902.10 / $1,233.00	Facility		$783.92	$902.10	$1,233.00
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $1,137.11 / $1,353.15 / $1,849.50	Facility	50	$1,137.11	$1,353.15	$1,849.50
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $151.62 / $180.42 / $246.60	Facility	80	$151.62	$180.42	$246.60
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 $4,397.64 / $9,001.70 / $26,542.00	Facility		$4,397.64	$9,001.70	$26,542.00