Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.94 / $131.85 / $217.77	Facility	26	$66.94	$131.85	$217.77
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $137.00 / $276.95 / $276.95	Facility	26	$137.00	$276.95	$276.95
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $60.07 / $134.91 / $8,105.48	Facility	26	$60.07	$134.91	$8,105.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $116.32 / $121.27	Facility	26	$97.25	$116.32	$121.27
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $80.18 / $80.18 / $80.89	Facility	26	$80.18	$80.18	$80.89
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,551.62 / $5,551.62 / $8,401.03	Facility	26	$5,551.62	$5,551.62	$8,401.03