Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $230.70 / $449.09 / $734.00	Facility	26	$230.70	$449.09	$734.00
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $267.80 / $1,850.96 / $1,850.96	Facility	26	$267.80	$1,850.96	$1,850.96
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $247.23 / $431.64 / $540.62	Facility	26	$247.23	$431.64	$540.62
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $322.30 / $389.55 / $410.04	Facility	26	$322.30	$389.55	$410.04
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $267.80 / $267.80 / $269.54	Facility	26	$267.80	$267.80	$269.54