Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $125.89 / $138.04	Facility	26	$72.44	$125.89	$138.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $114.82 / $141.25	Professional	26	$91.20	$114.82	$141.25
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $107.15 / $109.65	Facility	26	$89.13	$107.15	$109.65
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,122.02 / $1,122.02 / $1,122.02	Facility	26	$1,122.02	$1,122.02	$1,122.02