Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $102.33 / $177.83	Facility	26	$52.48	$102.33	$177.83
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $114.82 / $6,165.95	Facility	26	$77.62	$114.82	$6,165.95
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $91.20 / $100.00	Facility	26	$75.86	$91.20	$100.00
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $63.10	Facility	26	$63.10	$63.10	$63.10
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