Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.58 / $40.40 / $64.69	Facility	26	$20.58	$40.40	$64.69
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.22 / $100.00 / $297.00	Facility	26	$24.22	$100.00	$297.00
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $17.67 / $39.15 / $47.62	Facility	26	$17.67	$39.15	$47.62
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $28.42 / $35.35 / $37.40	Facility	26	$28.42	$35.35	$37.40
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $24.22 / $24.22 / $24.92	Facility	26	$24.22	$24.22	$24.92