Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $390.87 / $479.62 / $899.71	Facility	26	$390.87	$479.62	$899.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $292.29 / $411.38 / $463.17	Professional	26	$292.29	$411.38	$463.17
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $272.44 / $356.05 / $372.70	Facility	26	$272.44	$356.05	$372.70