Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $95.50 / $141.25	Facility	26	$64.57	$95.50	$141.25
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $91.20 / $2,238.72	Facility	26	$57.54	$91.20	$2,238.72
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $87.10 / $100.00	Facility	26	$72.44	$87.10	$100.00
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $60.26 / $60.26	Facility	26	$60.26	$60.26	$60.26
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility	26	$1,584.89	$1,584.89	$1,584.89