Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.91 / $91.15 / $148.63	Facility	26	$47.91	$91.15	$148.63
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $193.75 / $193.75	Facility	26	$100.00	$193.75	$193.75
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $41.23 / $88.74 / $1,574.04	Facility	26	$41.23	$88.74	$1,574.04
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $69.30 / $82.33 / $85.09	Facility	26	$69.30	$82.33	$85.09
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $56.17 / $56.17 / $57.58	Facility	26	$56.17	$56.17	$57.58
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $1,050.74 / $1,050.74 / $2,064.48	Facility	26	$1,050.74	$1,050.74	$2,064.48