Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.89 / $187.23 / $913.92	Facility	26	$113.89	$187.23	$913.92
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $137.26 / $214.26 / $5,335.97	Facility	26	$137.26	$214.26	$5,335.97
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $129.01 / $250.22 / $9,192.70	Facility	26	$129.01	$250.22	$9,192.70
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $166.10 / $201.34 / $204.35	Facility	26	$166.10	$201.34	$204.35
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $137.26 / $137.26 / $138.01	Facility	26	$137.26	$137.26	$138.01
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $5,335.97 / $5,335.97 / $9,269.74	Facility	26	$5,335.97	$5,335.97	$9,269.74