Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.64 / $111.64 / $123.70	Facility	26	$111.64	$111.64	$123.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $80.34 / $113.59 / $129.31	Professional	26	$80.34	$113.59	$129.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $83.93 / $102.51 / $146.19	Facility	26	$83.93	$102.51	$146.19