Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.01 / $31.74 / $51.84	Facility	26	$16.01	$31.74	$51.84
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $13.95 / $31.82 / $635.38	Facility	26	$13.95	$31.82	$635.38
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $23.63 / $28.23 / $28.81	Facility	26	$23.63	$28.23	$28.81
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $19.03 / $19.03 / $19.64	Facility	26	$19.03	$19.03	$19.64
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.45 / $446.45 / $782.93	Facility	26	$446.45	$446.45	$782.93