Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.73 / $141.22 / $233.19	Facility	26	$71.73	$141.22	$233.19
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $150.00 / $303.95 / $303.95	Facility	26	$150.00	$303.95	$303.95
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $66.02 / $144.77 / $8,105.48	Facility	26	$66.02	$144.77	$8,105.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $105.60 / $127.21 / $130.00	Facility	26	$105.60	$127.21	$130.00
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $86.07 / $86.07 / $87.74	Facility	26	$86.07	$86.07	$87.74
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