Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $202.64 / $400.20 / $667.60	Facility	26	$202.64	$400.20	$667.60
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $242.36 / $1,693.28 / $1,693.28	Facility	26	$242.36	$1,693.28	$1,693.28
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $226.38 / $384.54 / $491.09	Facility	26	$226.38	$384.54	$491.09
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $295.35 / $356.05 / $372.70	Facility	26	$295.35	$356.05	$372.70
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $242.36 / $242.36 / $245.41	Facility	26	$242.36	$242.36	$245.41