Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.00 / $138.31 / $279.92	Facility	26	$121.00	$138.31	$279.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.56 / $63.56 / $63.56	Facility	26	$63.56	$63.56	$63.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $106.54 / $122.64 / $143.60	Professional	26	$106.54	$122.64	$143.60
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $84.28 / $109.83 / $115.24	Facility	26	$84.28	$109.83	$115.24
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $63.56 / $63.56 / $63.56	Facility	26	$63.56	$63.56	$63.56
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,427.71 / $5,427.71 / $5,427.71	Facility	26	$5,427.71	$5,427.71	$5,427.71