Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $45.71 / $75.86	Facility	26	$22.91	$45.71	$75.86
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $52.48 / $1,819.70	Facility	26	$33.11	$52.48	$1,819.70
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $40.74 / $42.66	Facility	26	$33.88	$40.74	$42.66
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $28.18 / $28.18	Facility	26	$28.18	$28.18	$28.18
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