Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $147.91 / $707.95	Facility	26	$89.13	$147.91	$707.95
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $194.98 / $6,918.31	Facility	26	$125.89	$194.98	$6,918.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $154.88 / $158.49	Facility	26	$128.82	$154.88	$158.49
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,884.03 / $2,884.03 / $2,884.03	Facility	26	$2,884.03	$2,884.03	$2,884.03