Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.87 / $142.16 / $697.06	Facility	26	$86.87	$142.16	$697.06
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $104.20 / $345.15 / $345.15	Facility	26	$104.20	$345.15	$345.15
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $87.23 / $160.41 / $212.29	Facility	26	$87.23	$160.41	$212.29
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $125.32 / $150.53 / $153.43	Facility	26	$125.32	$150.53	$153.43
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $103.74 / $103.74 / $104.20	Facility	26	$103.74	$103.74	$104.20
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $346.39 / $346.39 / $679.90	Facility	26	$346.39	$346.39	$679.90