Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $70.79 / $114.82	Facility	26	$38.02	$70.79	$114.82
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $79.43 / $1,819.70	Facility	26	$50.12	$79.43	$1,819.70
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $61.66 / $64.57	Facility	26	$51.29	$61.66	$64.57
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $42.66 / $42.66	Facility	26	$42.66	$42.66	$42.66
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $724.44 / $724.44 / $724.44	Facility	26	$724.44	$724.44	$724.44