Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $194.70 / $194.70 / $215.70	Facility	26	$194.70	$194.70	$215.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $141.01 / $199.44 / $227.04	Professional	26	$141.01	$199.44	$227.04
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $121.52 / $170.18 / $178.75	Facility	26	$121.52	$170.18	$178.75