Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.58 / $45.39 / $77.25	Facility	26	$23.58	$45.39	$77.25
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.88 / $192.88 / $731.61	Facility	26	$27.88	$192.88	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $20.46 / $51.03 / $1,678.39	Facility	26	$20.46	$51.03	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $40.25 / $42.88	Facility	26	$31.36	$40.25	$42.88
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $27.88 / $27.88 / $28.09	Facility	26	$27.88	$27.88	$28.09
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