Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.22 / $145.47 / $709.68	Facility	26	$89.22	$145.47	$709.68
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $106.00 / $164.78 / $2,871.86	Facility	26	$106.00	$164.78	$2,871.86
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $100.58 / $195.07 / $7,019.31	Facility	26	$100.58	$195.07	$7,019.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $127.60 / $155.09 / $158.79	Facility	26	$127.60	$155.09	$158.79
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $106.00 / $106.00 / $106.02	Facility	26	$106.00	$106.00	$106.02
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,871.86 / $2,871.86 / $4,863.74	Facility	26	$2,871.86	$2,871.86	$4,863.74