Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.54 / $583.25 / $893.45	Facility	26	$256.54	$583.25	$893.45
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $347.90 / $1,205.01 / $1,205.01	Facility	26	$347.90	$1,205.01	$1,205.01
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $242.73 / $555.59 / $797.81	Facility	26	$242.73	$555.59	$797.81
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $362.11 / $491.78 / $523.94	Facility	26	$362.11	$491.78	$523.94
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $347.90 / $347.90 / $357.37	Facility	26	$347.90	$347.90	$357.37
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $468.86 / $468.86 / $740.87	Facility	26	$468.86	$468.86	$740.87