Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.86 / $120.21 / $657.11	Facility	26	$111.86	$120.21	$657.11
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.53 / $103.40 / $153.82	Professional	26	$81.53	$103.40	$153.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $106.49 / $148.29 / $272.14	Professional	26	$106.49	$148.29	$272.14
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $249.44 / $505.63 / $533.04	Facility	26	$249.44	$505.63	$533.04