Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $91.20 / $147.91	Facility	26	$46.77	$91.20	$147.91
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $81.28 / $1,479.11	Facility	26	$46.77	$81.28	$1,479.11
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $83.18 / $85.11	Facility	26	$69.18	$83.18	$85.11
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $56.23 / $57.54	Facility	26	$56.23	$56.23	$57.54
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility	26	$1,047.13	$1,047.13	$1,047.13