Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.04 / $65.95 / $107.61	Facility	26	$34.04	$65.95	$107.61
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $40.22 / $278.24 / $949.44	Facility	26	$40.22	$278.24	$949.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $29.14 / $73.25 / $2,162.39	Facility	26	$29.14	$73.25	$2,162.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $44.59 / $58.71 / $60.30	Facility	26	$44.59	$58.71	$60.30
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $40.22 / $40.22 / $40.32	Facility	26	$40.22	$40.22	$40.32
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