Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.74 / $125.94 / $253.19	Facility	26	$109.74	$125.94	$253.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.98 / $58.98 / $58.98	Facility	26	$58.98	$58.98	$58.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $96.68 / $114.93 / $129.40	Professional	26	$96.68	$114.93	$129.40
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $77.42 / $99.65 / $106.11	Facility	26	$77.42	$99.65	$106.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $58.98 / $58.98 / $58.98	Facility	26	$58.98	$58.98	$58.98
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