Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.40 / $201.86 / $330.21	Facility	26	$103.40	$201.86	$330.21
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $217.55 / $1,072.58 / $1,072.58	Facility	26	$217.55	$1,072.58	$1,072.58
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $104.68 / $200.10 / $388.65	Facility	26	$104.68	$200.10	$388.65
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $151.80 / $180.69 / $186.93	Facility	26	$151.80	$180.69	$186.93
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $125.93 / $125.93 / $126.13	Facility	26	$125.93	$125.93	$126.13
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $513.03 / $513.03 / $838.61	Facility	26	$513.03	$513.03	$838.61