Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $163.77 / $187.63 / $377.93	Facility	26	$163.77	$187.63	$377.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.50 / $87.50 / $87.50	Facility	26	$87.50	$87.50	$87.50
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $145.38 / $173.25 / $195.06	Professional	26	$145.38	$173.25	$195.06
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $112.70 / $149.85 / $153.68	Facility	26	$112.70	$149.85	$153.68
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $87.50 / $87.50 / $87.50	Facility	26	$87.50	$87.50	$87.50
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $8,401.03 / $8,401.03 / $8,401.03	Facility	26	$8,401.03	$8,401.03	$8,401.03