Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $89.13 / $239.88	Facility	26	$48.98	$89.13	$239.88
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $69.18 / $114.82	Facility	26	$43.65	$69.18	$114.82
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $79.43 / $93.33	Facility	26	$66.07	$79.43	$93.33
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $54.95 / $54.95	Facility	26	$54.95	$54.95	$54.95
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	26	$218.78	$218.78	$218.78