Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.76 / $95.24 / $192.16	Facility	26	$83.76	$95.24	$192.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.43 / $88.62 / $91.67	Professional	26	$38.43	$88.62	$91.67
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $57.17 / $76.38 / $79.06	Facility	26	$57.17	$76.38	$79.06
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,177.68 / $1,177.68 / $1,177.68	Facility	26	$1,177.68	$1,177.68	$1,177.68