Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.45 / $141.62 / $174.88	Facility	26	$87.45	$141.62	$174.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $86.70 / $104.04 / $128.32	Professional	26	$86.70	$104.04	$128.32
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $147.57 / $162.31 / $165.21	Facility	26	$147.57	$162.31	$165.21