Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $114.82 / $190.55	Facility	26	$57.54	$114.82	$190.55
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $102.33 / $7,413.10	Facility	26	$63.10	$102.33	$7,413.10
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $102.33 / $107.15	Facility	26	$85.11	$102.33	$107.15
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	26	$69.18	$69.18	$69.18
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