Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $162.18 / $309.03	Facility	26	$141.25	$162.18	$309.03
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $186.21 / $302.00	Facility	26	$144.54	$186.21	$302.00
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $158.49 / $229.09	Facility	26	$131.83	$158.49	$229.09
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $125.89	Facility	26	$109.65	$109.65	$125.89