Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $38.02 / $63.10	Facility	26	$19.05	$38.02	$63.10
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $19.50 / $33.88 / $630.96	Facility	26	$19.50	$33.88	$630.96
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $33.88 / $34.67	Facility	26	$28.18	$33.88	$34.67
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $22.91 / $23.44	Facility	26	$22.91	$22.91	$23.44
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	26	$446.68	$446.68	$446.68