Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $195.11 / $195.11 / $213.79	Facility	26	$195.11	$195.11	$213.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $162.44 / $192.29 / $221.82	Professional	26	$162.44	$192.29	$221.82
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $128.88 / $170.07 / $178.22	Facility	26	$128.88	$170.07	$178.22