Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.17 / $51.04 / $157.38	Facility	26	$41.17	$51.04	$157.38
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $38.51 / $188.97 / $188.97	Facility	26	$38.51	$188.97	$188.97
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $42.24 / $76.59 / $110.53	Facility	26	$42.24	$76.59	$110.53
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $43.98 / $53.60 / $87.10	Facility	26	$43.98	$53.60	$87.10
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $36.56 / $36.56 / $38.51	Facility	26	$36.56	$36.56	$38.51