Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $39.81 / $64.57	Facility	26	$19.95	$39.81	$64.57
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $38.02 / $51.29	Facility	26	$22.91	$38.02	$51.29
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $35.48 / $37.15	Facility	26	$28.84	$35.48	$37.15
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $23.99 / $25.12	Facility	26	$23.99	$23.99	$25.12