Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.97 / $77.64 / $128.35	Facility	26	$40.97	$77.64	$128.35
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.44 / $100.00 / $949.44	Facility	26	$48.44	$100.00	$949.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $35.03 / $87.24 / $2,377.71	Facility	26	$35.03	$87.24	$2,377.71
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $54.88 / $68.42 / $73.44	Facility	26	$54.88	$68.42	$73.44
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $48.44 / $48.44 / $48.92	Facility	26	$48.44	$48.44	$48.92
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $949.44 / $949.44 / $4,053.27	Facility	26	$949.44	$949.44	$4,053.27