Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.63 / $136.91 / $276.61	Facility	26	$119.63	$136.91	$276.61
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.29 / $63.29 / $63.29	Facility	26	$63.29	$63.29	$63.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $105.06 / $125.51 / $141.31	Professional	26	$105.06	$125.51	$141.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $56.03 / $94.62 / $111.22	Facility	26	$56.03	$94.62	$111.22
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $63.29 / $63.29 / $63.29	Facility	26	$63.29	$63.29	$63.29
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $385.75 / $385.75 / $385.75	Facility	26	$385.75	$385.75	$385.75