Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $130.30 / $130.30 / $193.93	Facility	26	$130.30	$130.30	$193.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.74 / $88.74 / $88.74	Facility	26	$88.74	$88.74	$88.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $136.36 / $177.79 / $200.54	Professional	26	$136.36	$177.79	$200.54
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $110.95 / $152.09 / $155.44	Facility	26	$110.95	$152.09	$155.44
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $88.74 / $88.74 / $88.74	Facility	26	$88.74	$88.74	$88.74
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $3,043.22 / $3,043.22 / $3,043.22	Facility	26	$3,043.22	$3,043.22	$3,043.22