Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $81.67 / $131.41	Facility	26	$41.65	$81.67	$131.41
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $49.36 / $100.00 / $731.61	Facility	26	$49.36	$100.00	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $46.68 / $91.02 / $1,678.39	Facility	26	$46.68	$91.02	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $56.35 / $71.41 / $74.67	Facility	26	$56.35	$71.41	$74.67
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $49.36 / $49.36 / $49.83	Facility	26	$49.36	$49.36	$49.83
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