Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $72.44 / $97.72	Facility	26	$42.66	$72.44	$97.72
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $56.23 / $4,466.84	Facility	26	$30.90	$56.23	$4,466.84
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $74.13 / $77.62	Facility	26	$42.66	$74.13	$77.62
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $52.48	Facility	26	$51.29	$51.29	$52.48
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Facility	26	$3,467.37	$3,467.37	$3,467.37