Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $114.82 / $134.90	Facility	26	$72.44	$114.82	$134.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $114.82 / $138.04	Professional	26	$102.33	$114.82	$138.04
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $107.15 / $112.20	Facility	26	$89.13	$107.15	$112.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $63.10 / $89.13	Facility	26	$13.49	$63.10	$89.13
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $8,317.64 / $8,317.64 / $8,317.64	Facility	26	$8,317.64	$8,317.64	$8,317.64