Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.92 / $149.71 / $305.02	Facility	26	$126.92	$149.71	$305.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $116.38 / $139.53 / $157.65	Professional	26	$116.38	$139.53	$157.65
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $81.40 / $112.56 / $119.93	Facility	26	$81.40	$112.56	$119.93
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $420.37 / $420.37 / $420.37	Facility	26	$420.37	$420.37	$420.37