Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $51.29 / $85.11	Facility	26	$25.12	$51.29	$85.11
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $45.71 / $489.78	Facility	26	$26.92	$45.71	$489.78
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $45.71 / $46.77	Facility	26	$37.15	$45.71	$46.77
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	26	$30.90	$30.90	$30.90
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