Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.54 / $125.00 / $275.08	Facility	26	$123.54	$125.00	$275.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $76.06 / $89.50 / $100.06	Professional	26	$76.06	$89.50	$100.06
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $111.38 / $111.38 / $111.38	Facility	26	$111.38	$111.38	$111.38