Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $377.70 / $377.70 / $415.47	Facility	26	$377.70	$377.70	$415.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $304.07 / $358.61 / $430.23	Professional	26	$304.07	$358.61	$430.23
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $272.44 / $328.60 / $360.10	Facility	26	$272.44	$328.60	$360.10