Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $169.82 / $275.42	Facility	26	$85.11	$169.82	$275.42
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $147.91 / $7,413.10	Facility	26	$91.20	$147.91	$7,413.10
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $151.36 / $154.88	Facility	26	$123.03	$151.36	$154.88
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $102.33 / $102.33	Facility	26	$102.33	$102.33	$102.33
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,495.41 / $5,495.41 / $5,495.41	Facility	26	$5,495.41	$5,495.41	$5,495.41