Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.68 / $150.86 / $245.75	Facility	26	$77.68	$150.86	$245.75
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $92.31 / $157.00 / $949.44	Facility	26	$92.31	$157.00	$949.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $66.03 / $167.84 / $2,162.39	Facility	26	$66.03	$167.84	$2,162.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $110.25 / $133.90 / $138.72	Facility	26	$110.25	$133.90	$138.72
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $92.31 / $92.31 / $92.41	Facility	26	$92.31	$92.31	$92.41
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $949.44 / $949.44 / $1,526.97	Facility	26	$949.44	$949.44	$1,526.97