Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $264.85 / $264.85 / $399.13	Facility	26	$264.85	$264.85	$399.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $260.05 / $368.67 / $419.69	Professional	26	$260.05	$368.67	$419.69
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $242.73 / $316.79 / $341.36	Facility	26	$242.73	$316.79	$341.36