Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.48 / $190.92 / $312.12	Facility	26	$96.48	$190.92	$312.12
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $799.28 / $799.28 / $799.28	Facility	26	$799.28	$799.28	$799.28
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $83.39 / $177.86 / $235.36	Facility	26	$83.39	$177.86	$235.36
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $139.05 / $166.99 / $172.72	Facility	26	$139.05	$166.99	$172.72
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $115.06 / $115.06 / $115.62	Facility	26	$115.06	$115.06	$115.62