Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.68 / $79.68 / $79.68	Facility		$79.68	$79.68	$79.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.80 / $79.68 / $79.68	Professional		$76.80	$79.68	$79.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.59 / $84.00 / $164.64	Facility		$81.59	$84.00	$164.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $81.59 / $81.59	Professional		$81.59	$81.59	$81.59