Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.14 / $159.27 / $242.66	Facility	26	$81.14	$159.27	$242.66
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $98.26 / $857.00 / $2,533.52	Facility	26	$98.26	$857.00	$2,533.52
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $65.41 / $173.49 / $5,739.12	Facility	26	$65.41	$173.49	$5,739.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $114.57 / $143.38 / $145.52	Facility	26	$114.57	$143.38	$145.52
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $98.26 / $98.26 / $125.00	Facility	26	$98.26	$98.26	$125.00
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