Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $204.17 / $223.87	Facility	26	$117.49	$204.17	$223.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $194.98 / $234.42	Professional	26	$93.33	$194.98	$234.42
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $147.91 / $208.93	Facility	26	$144.54	$147.91	$208.93
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $177.83 / $186.21	Facility	26	$151.36	$177.83	$186.21