Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.44 / $113.72 / $191.49	Facility	26	$57.44	$113.72	$191.49
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 / $116.73 / $8,105.48	Facility	26	$52.25	$116.73	$8,105.48
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $84.15 / $101.43 / $106.53	Facility	26	$84.15	$101.43	$106.53
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $69.31 / $69.31 / $69.92	Facility	26	$69.31	$69.31	$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