Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.52 / $117.77 / $191.43	Facility	26	$59.52	$117.77	$191.43
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $123.00 / $252.69 / $252.69	Facility	26	$123.00	$252.69	$252.69
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $55.69 / $122.79 / $8,105.48	Facility	26	$55.69	$122.79	$8,105.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $88.55 / $105.99 / $109.48	Facility	26	$88.55	$105.99	$109.48
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $72.93 / $72.93 / $73.58	Facility	26	$72.93	$72.93	$73.58
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