Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.85 / $102.00 / $170.56	Facility	26	$52.85	$102.00	$170.56
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $61.24 / $95.24 / $2,533.52	Facility	26	$61.24	$95.24	$2,533.52
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $59.41 / $111.42 / $5,739.12	Facility	26	$59.41	$111.42	$5,739.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $69.58 / $89.78 / $94.47	Facility	26	$69.58	$89.78	$94.47
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $61.24 / $61.24 / $62.51	Facility	26	$61.24	$61.24	$62.51
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,533.52 / $2,533.52 / $4,053.27	Facility	26	$2,533.52	$2,533.52	$4,053.27