Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.59 / $112.61 / $187.50	Facility	26	$56.59	$112.61	$187.50
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $118.00 / $240.42 / $240.42	Facility	26	$118.00	$240.42	$240.42
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $52.25 / $115.21 / $8,105.48	Facility	26	$52.25	$115.21	$8,105.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $84.07 / $100.54 / $104.52	Facility	26	$84.07	$100.54	$104.52
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $68.86 / $68.86 / $69.92	Facility	26	$68.86	$68.86	$69.92
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