Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $591.82 / $712.36 / $1,153.76	Facility	26	$591.82	$712.36	$1,153.76
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $445.75 / $665.81 / $1,482.02	Facility	26	$445.75	$665.81	$1,482.02
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $319.30 / $707.60 / $859.36	Facility	26	$319.30	$707.60	$859.36
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $536.79 / $621.83 / $669.12	Facility	26	$536.79	$621.83	$669.12
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $445.75 / $445.75 / $446.95	Facility	26	$445.75	$445.75	$446.95