Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.19 / $74.23 / $126.93	Facility	26	$37.19	$74.23	$126.93
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $44.39 / $100.00 / $731.61	Facility	26	$44.39	$100.00	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $34.10 / $85.60 / $1,678.39	Facility	26	$34.10	$85.60	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $52.92 / $65.41 / $70.34	Facility	26	$52.92	$65.41	$70.34
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $44.39 / $44.39 / $44.79	Facility	26	$44.39	$44.39	$44.79
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