Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $331.13 / $389.05	Facility	26	$104.71	$331.13	$389.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $295.12 / $331.13 / $389.05	Professional	26	$295.12	$331.13	$389.05
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $239.88 / $295.12 / $316.23	Facility	26	$239.88	$295.12	$316.23
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $169.82 / $245.47	Facility	26	$36.31	$169.82	$245.47
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $776.25 / $776.25 / $776.25	Facility	26	$776.25	$776.25	$776.25