Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $336.34 / $407.70 / $660.45	Facility	26	$336.34	$407.70	$660.45
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $251.81 / $380.00 / $843.20	Facility	26	$251.81	$380.00	$843.20
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $181.66 / $403.82 / $490.43	Facility	26	$181.66	$403.82	$490.43
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $303.05 / $353.33 / $380.12	Facility	26	$303.05	$353.33	$380.12
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $251.81 / $251.81 / $253.23	Facility	26	$251.81	$251.81	$253.23