Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $294.72 / $353.10 / $558.28	Facility	26	$294.72	$353.10	$558.28
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $222.88 / $330.50 / $737.24	Facility	26	$222.88	$330.50	$737.24
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $158.41 / $354.52 / $430.56	Facility	26	$158.41	$354.52	$430.56
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $267.04 / $309.61 / $336.05	Facility	26	$267.04	$309.61	$336.05
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $222.88 / $222.88 / $223.47	Facility	26	$222.88	$222.88	$223.47