Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $72.89 / $121.52	Facility	26	$38.02	$72.89	$121.52
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $42.96 / $100.00 / $731.61	Facility	26	$42.96	$100.00	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $42.44 / $81.48 / $1,678.39	Facility	26	$42.44	$81.48	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $50.47 / $62.29 / $67.31	Facility	26	$50.47	$62.29	$67.31
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $42.96 / $42.96 / $45.30	Facility	26	$42.96	$42.96	$45.30
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $731.61 / $731.61 / $1,177.68	Facility	26	$731.61	$731.61	$1,177.68