Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.61 / $86.34 / $142.41	Facility	26	$43.61	$86.34	$142.41
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $52.10 / $175.59 / $731.61	Facility	26	$52.10	$175.59	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $38.13 / $94.65 / $1,678.39	Facility	26	$38.13	$94.65	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $58.80 / $76.38 / $79.06	Facility	26	$58.80	$76.38	$79.06
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $52.10 / $52.10 / $52.10	Facility	26	$52.10	$52.10	$52.10
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