Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.97 / $181.65 / $350.85	Facility	26	$109.97	$181.65	$350.85
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $135.27 / $454.15 / $454.15	Facility	26	$135.27	$454.15	$454.15
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $95.48 / $196.65 / $254.86	Facility	26	$95.48	$196.65	$254.86
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $162.80 / $193.63 / $198.99	Facility	26	$162.80	$193.63	$198.99
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $132.72 / $132.72 / $135.27	Facility	26	$132.72	$132.72	$135.27