Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $66.07 / $107.15	Facility	26	$33.88	$66.07	$107.15
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $74.13 / $2,344.23	Facility	26	$46.77	$74.13	$2,344.23
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $58.88 / $60.26	Facility	26	$47.86	$58.88	$60.26
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $39.81 / $40.74	Facility	26	$39.81	$39.81	$40.74
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $954.99 / $954.99 / $954.99	Facility	26	$954.99	$954.99	$954.99