Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.37 / $103.03 / $182.98	Facility	26	$62.37	$103.03	$182.98
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $115.50 / $248.27 / $248.27	Facility	26	$115.50	$248.27	$248.27
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $40.79 / $76.75 / $490.69	Facility	26	$40.79	$76.75	$490.69
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $56.43 / $105.49 / $111.22	Facility	26	$56.43	$105.49	$111.22
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $74.95 / $74.95 / $75.20	Facility	26	$74.95	$74.95	$75.20
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $385.75	Facility	26	$346.39	$346.39	$385.75