Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.06 / $133.04 / $204.47	Facility	26	$59.06	$133.04	$204.47
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $79.73 / $274.01 / $274.01	Facility	26	$79.73	$274.01	$274.01
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $55.80 / $128.40 / $366.34	Facility	26	$55.80	$128.40	$366.34
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $82.81 / $113.23 / $119.93	Facility	26	$82.81	$113.23	$119.93
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $79.73 / $79.73 / $81.80	Facility	26	$79.73	$79.73	$81.80
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $233.85 / $233.85 / $420.37	Facility	26	$233.85	$233.85	$420.37