Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.62 / $182.69 / $298.49	Facility	26	$92.62	$182.69	$298.49
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $767.44 / $767.44 / $767.44	Facility	26	$767.44	$767.44	$767.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $90.57 / $185.62 / $2,217.21	Facility	26	$90.57	$185.62	$2,217.21
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $130.91 / $160.31 / $165.49	Facility	26	$130.91	$160.31	$165.49
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $110.53 / $110.53 / $111.05	Facility	26	$110.53	$110.53	$111.05
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,387.45 / $1,387.45 / $2,298.07	Facility	26	$1,387.45	$1,387.45	$2,298.07