Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.22 / $58.40 / $93.99	Facility	26	$29.22	$58.40	$93.99
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.72 / $100.00 / $731.61	Facility	26	$34.72	$100.00	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $25.42 / $64.54 / $1,678.39	Facility	26	$25.42	$64.54	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $40.18 / $50.92 / $52.40	Facility	26	$40.18	$50.92	$52.40
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $34.72 / $34.72 / $34.88	Facility	26	$34.72	$34.72	$34.88
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