Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.56 / $224.18 / $366.47	Facility	26	$113.56	$224.18	$366.47
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $209.42 / $455.64 / $455.64	Facility	26	$209.42	$455.64	$455.64
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $110.82 / $226.56 / $698.97	Facility	26	$110.82	$226.56	$698.97
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $163.90 / $197.84 / $203.01	Facility	26	$163.90	$197.84	$203.01
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $134.99 / $134.99 / $136.19	Facility	26	$134.99	$134.99	$136.19
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