Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.95 / $70.51 / $115.86	Facility	26	$35.95	$70.51	$115.86
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $42.50 / $100.00 / $949.44	Facility	26	$42.50	$100.00	$949.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $31.31 / $78.19 / $2,162.39	Facility	26	$31.31	$78.19	$2,162.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $48.51 / $62.05 / $64.31	Facility	26	$48.51	$62.05	$64.31
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $42.50 / $42.50 / $43.04	Facility	26	$42.50	$42.50	$43.04
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