Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Medcost Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $165.96 / $173.78	Professional		$138.04	$165.96	$173.78
Medcost Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $97.72 / $208.93	Facility		$74.13	$97.72	$208.93