Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.63 / $137.63 / $671.73	Facility	26	$84.63	$137.63	$671.73
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $101.00 / $157.16 / $2,871.86	Facility	26	$101.00	$157.16	$2,871.86
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $95.49 / $185.19 / $7,019.31	Facility	26	$95.49	$185.19	$7,019.31
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $121.50 / $146.63 / $150.75	Facility	26	$121.50	$146.63	$150.75
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $101.00 / $101.00 / $101.02	Facility	26	$101.00	$101.00	$101.02
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