Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.44 / $38.47 / $62.82	Facility	26	$19.44	$38.47	$62.82
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $23.10 / $50.00 / $731.61	Facility	26	$23.10	$50.00	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $22.06 / $42.80 / $1,678.39	Facility	26	$22.06	$42.80	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $27.56 / $33.58 / $34.84	Facility	26	$27.56	$33.58	$34.84
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 $731.61 / $731.61 / $1,177.68	Facility	26	$731.61	$731.61	$1,177.68