Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $134.51 / $264.35 / $431.58	Facility	26	$134.51	$264.35	$431.58
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $246.99 / $535.50 / $535.50	Facility	26	$246.99	$535.50	$535.50
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $131.07 / $268.33 / $698.97	Facility	26	$131.07	$268.33	$698.97
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $192.50 / $232.59 / $239.36	Facility	26	$192.50	$232.59	$239.36
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $159.46 / $159.46 / $159.94	Facility	26	$159.46	$159.46	$159.94
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