Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.59 / $31.39 / $51.84	Facility	26	$15.59	$31.39	$51.84
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $18.57 / $129.91 / $949.44	Facility	26	$18.57	$129.91	$949.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $13.95 / $35.39 / $2,162.39	Facility	26	$13.95	$35.39	$2,162.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $21.56 / $27.14 / $28.81	Facility	26	$21.56	$27.14	$28.81
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $18.57 / $18.57 / $18.73	Facility	26	$18.57	$18.57	$18.73
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