Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $217.41 / $248.42 / $502.13	Facility	26	$217.41	$248.42	$502.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.94 / $114.94 / $114.94	Facility	26	$114.94	$114.94	$114.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $191.93 / $220.93 / $258.33	Professional	26	$191.93	$220.93	$258.33
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $152.88 / $197.84 / $203.01	Facility	26	$152.88	$197.84	$203.01
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $114.94 / $114.94 / $114.94	Facility	26	$114.94	$114.94	$114.94
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $782.93 / $782.93 / $782.93	Facility	26	$782.93	$782.93	$782.93