Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.00 / $125.00 / $337.00	Facility	26	$125.00	$125.00	$337.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $76.59 / $99.00 / $103.13	Professional	26	$76.59	$99.00	$103.13
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $92.22 / $92.22 / $124.31	Facility	26	$92.22	$92.22	$124.31