Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $14.79 / $22.91	Facility	26	$10.23	$14.79	$22.91
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $17.78 / $165.96	Facility	26	$10.47	$17.78	$165.96
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $17.78 / $18.20	Facility	26	$14.79	$17.78	$18.20
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $213.80 / $213.80 / $213.80	Facility	26	$213.80	$213.80	$213.80