Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $338.84 / $398.11	Facility	26	$104.71	$338.84	$398.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $295.12 / $331.13 / $407.38	Professional	26	$295.12	$331.13	$407.38
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $309.03 / $316.23	Facility	26	$257.04	$309.03	$316.23
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $181.97 / $257.04	Facility	26	$38.90	$181.97	$257.04
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $851.14 / $851.14 / $851.14	Facility	26	$851.14	$851.14	$851.14