Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.84 / $112.90 / $187.31	Facility	26	$56.84	$112.90	$187.31
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $118.00 / $238.74 / $238.74	Facility	26	$118.00	$238.74	$238.74
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $53.63 / $115.97 / $8,105.48	Facility	26	$53.63	$115.97	$8,105.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $83.50 / $99.65 / $105.82	Facility	26	$83.50	$99.65	$105.82
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $68.86 / $68.86 / $69.45	Facility	26	$68.86	$68.86	$69.45
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