Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $269.15 / $436.52	Facility	26	$194.98	$269.15	$436.52
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $134.90 / $234.42 / $537.03	Facility	26	$134.90	$234.42	$537.03
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $234.42 / $239.88	Facility	26	$194.98	$234.42	$239.88
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $162.18 / $162.18 / $162.18	Facility	26	$162.18	$162.18	$162.18
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