Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.35 / $37.89 / $62.95	Facility	26	$19.35	$37.89	$62.95
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $77.22 / $80.00 / $80.00	Facility	26	$77.22	$80.00	$80.00
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $16.73 / $37.90 / $635.38	Facility	26	$16.73	$37.90	$635.38
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $28.03 / $33.57 / $34.68	Facility	26	$28.03	$33.57	$34.68
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $23.10 / $23.10 / $23.31	Facility	26	$23.10	$23.10	$23.31
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $446.45 / $446.45 / $782.93	Facility	26	$446.45	$446.45	$782.93