Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.16 / $51.26 / $80.73	Facility	26	$26.16	$51.26	$80.73
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $31.26 / $100.00 / $949.44	Facility	26	$31.26	$100.00	$949.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $28.43 / $55.96 / $2,377.71	Facility	26	$28.43	$55.96	$2,377.71
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $34.29 / $45.16 / $46.51	Facility	26	$34.29	$45.16	$46.51
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $31.26 / $31.26 / $31.53	Facility	26	$31.26	$31.26	$31.53
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $949.44 / $949.44 / $4,053.27	Facility	26	$949.44	$949.44	$4,053.27