Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.79 / $141.21 / $599.16	Facility	26	$72.79	$141.21	$599.16
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $140.00 / $296.70 / $296.70	Facility	26	$140.00	$296.70	$296.70
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $62.62 / $142.08 / $2,015.51	Facility	26	$62.62	$142.08	$2,015.51
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $95.55 / $127.97 / $129.31	Facility	26	$95.55	$127.97	$129.31
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $88.20 / $88.20 / $89.24	Facility	26	$88.20	$88.20	$89.24
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