Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $147.91 / $239.88	Facility	26	$93.33	$147.91	$239.88
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $173.78 / $6,165.95	Facility	26	$107.15	$173.78	$6,165.95
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $144.54 / $144.54	Facility	26	$114.82	$144.54	$144.54
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $125.89	Facility	26	$97.72	$97.72	$125.89
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility	26	$2,511.89	$2,511.89	$2,511.89