Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $115.85 / $115.85 / $177.43	Facility	26	$115.85	$115.85	$177.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $115.86 / $163.79 / $186.45	Professional	26	$115.86	$163.79	$186.45
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $108.04 / $141.13 / $149.41	Facility	26	$108.04	$141.13	$149.41