Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.76 / $140.69 / $229.81	Facility	26	$70.76	$140.69	$229.81
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $85.16 / $131.66 / $2,533.52	Facility	26	$85.16	$131.66	$2,533.52
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $61.69 / $151.86 / $5,739.12	Facility	26	$61.69	$151.86	$5,739.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $102.85 / $124.07 / $127.30	Facility	26	$102.85	$124.07	$127.30
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $85.16 / $85.16 / $85.46	Facility	26	$85.16	$85.16	$85.46
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