Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $489.78 / $851.14 / $912.01	Facility	26	$489.78	$851.14	$912.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $380.19 / $794.33 / $954.99	Professional	26	$380.19	$794.33	$954.99
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $616.60 / $707.95 / $776.25	Facility	26	$616.60	$707.95	$776.25
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $17,782.79 / $17,782.79 / $17,782.79	Facility	26	$17,782.79	$17,782.79	$17,782.79