Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $239.88 / $389.05	Facility	26	$125.89	$239.88	$389.05
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $213.80 / $7,413.10	Facility	26	$123.03	$213.80	$7,413.10
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $186.21 / $218.78 / $229.09	Facility	26	$186.21	$218.78	$229.09
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $158.49	Facility	26	$154.88	$154.88	$158.49
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $9,332.54 / $9,332.54 / $9,332.54	Facility	26	$9,332.54	$9,332.54	$9,332.54