Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $69.18 / $112.20	Facility	26	$37.15	$69.18	$112.20
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $77.62 / $87.10	Facility	26	$39.81	$77.62	$87.10
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $66.07 / $70.79	Facility	26	$52.48	$66.07	$70.79
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $47.86 / $48.98	Facility	26	$47.86	$47.86	$48.98