Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $388.96 / $444.08 / $890.80	Facility	26	$388.96	$444.08	$890.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $290.04 / $406.63 / $462.89	Professional	26	$290.04	$406.63	$462.89
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $274.70 / $353.33 / $380.12	Facility	26	$274.70	$353.33	$380.12