Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $446.68 / $741.31	Facility	26	$323.59	$446.68	$741.31
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $257.04 / $407.38 / $512.86	Facility	26	$257.04	$407.38	$512.86
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $323.59 / $389.05 / $407.38	Facility	26	$323.59	$389.05	$407.38
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	26	$269.15	$269.15	$269.15