Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.58 / $67.58 / $67.58	Facility		$67.58	$67.58	$67.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.14 / $67.58 / $67.58	Professional		$65.14	$67.58	$67.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.20 / $71.23 / $139.63	Facility		$69.20	$71.23	$139.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.20 / $69.20 / $69.20	Professional		$69.20	$69.20	$69.20