Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $380.19 / $407.38	Facility	26	$213.80	$380.19	$407.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $346.74 / $416.87	Professional	26	$165.96	$346.74	$416.87
Moda Health Facility/Professional Facility Modifier 26 Low / Median / High Price $263.03 / $263.03 / $263.03	Facility	26	$263.03	$263.03	$263.03
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $316.23 / $338.84	Facility	26	$269.15	$316.23	$338.84