Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $51.29 / $70.79	Facility	26	$30.90	$51.29	$70.79
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $38.90 / $316.23	Facility	26	$20.42	$38.90	$316.23
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $53.70 / $56.23	Facility	26	$29.51	$53.70	$56.23
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $37.15 / $38.02	Facility	26	$37.15	$37.15	$38.02
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	26	$346.74	$346.74	$346.74