Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.58 / $52.12 / $85.56	Facility	26	$26.58	$52.12	$85.56
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $31.71 / $221.60 / $731.61	Facility	26	$31.71	$221.60	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $30.13 / $58.44 / $1,678.39	Facility	26	$30.13	$58.44	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $36.26 / $46.26 / $47.60	Facility	26	$36.26	$46.26	$47.60
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $31.71 / $31.71 / $31.99	Facility	26	$31.71	$31.71	$31.99
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