Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.19 / $91.85 / $518.72	Facility	26	$86.19	$91.85	$518.72
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.44 / $96.89 / $125.96	Professional	26	$76.44	$96.89	$125.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $87.20 / $121.11 / $222.85	Professional	26	$87.20	$121.11	$222.85
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $203.97 / $396.63 / $428.55	Facility	26	$203.97	$396.63	$428.55