Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $506.98 / $611.58 / $990.60	Facility	26	$506.98	$611.58	$990.60
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $380.97 / $569.77 / $1,270.10	Facility	26	$380.97	$569.77	$1,270.10
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $272.49 / $606.82 / $736.97	Facility	26	$272.49	$606.82	$736.97
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $460.05 / $533.23 / $571.88	Facility	26	$460.05	$533.23	$571.88
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $380.97 / $380.97 / $383.88	Facility	26	$380.97	$380.97	$383.88