Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $137.33 / $164.12 / $185.07	Facility	26	$137.33	$164.12	$185.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $112.07 / $158.54 / $180.52	Professional	26	$112.07	$158.54	$180.52
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $112.75 / $165.20 / $275.37	Facility	26	$112.75	$165.20	$275.37