Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $338.84 / $512.86 / $676.08	Facility	26	$338.84	$512.86	$676.08
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $316.23 / $616.60	Facility	26	$223.87	$316.23	$616.60
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $398.11 / $467.74 / $501.19	Facility	26	$398.11	$467.74	$501.19
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $331.13 / $331.13 / $338.84	Facility	26	$331.13	$331.13	$338.84
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,137.96 / $2,137.96 / $2,137.96	Facility	26	$2,137.96	$2,137.96	$2,137.96