Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $38.90 / $190.55	Facility	26	$22.91	$38.90	$190.55
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $48.98 / $61.66	Facility	26	$26.92	$48.98	$61.66
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $41.69 / $42.66	Facility	26	$33.88	$41.69	$42.66
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $28.18 / $28.84	Facility	26	$28.18	$28.18	$28.84