Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.47 / $70.69 / $168.75	Facility	26	$48.47	$70.69	$168.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.95 / $57.54 / $70.97	Professional	26	$47.95	$57.54	$70.97
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $91.55 / $105.12 / $138.66	Facility	26	$91.55	$105.12	$138.66