Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.48 / $153.44 / $230.52	Facility	26	$76.48	$153.44	$230.52
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $93.77 / $144.61 / $323.95	Facility	26	$93.77	$144.61	$323.95
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $77.90 / $142.69 / $176.64	Facility	26	$77.90	$142.69	$176.64
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $98.49 / $129.97 / $141.37	Facility	26	$98.49	$129.97	$141.37
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $93.77 / $93.77 / $96.43	Facility	26	$93.77	$93.77	$96.43