Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.56 / $115.95 / $192.81	Facility	26	$58.56	$115.95	$192.81
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $119.00 / $239.22 / $239.22	Facility	26	$119.00	$239.22	$239.22
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $51.94 / $118.24 / $3,447.33	Facility	26	$51.94	$118.24	$3,447.33
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $85.18 / $102.09 / $107.20	Facility	26	$85.18	$102.09	$107.20
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $70.84 / $70.84 / $71.12	Facility	26	$70.84	$70.84	$71.12
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $3,312.81 / $3,312.81 / $5,551.62	Facility	26	$3,312.81	$3,312.81	$5,551.62