Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.22 / $57.36 / $95.31	Facility	26	$29.22	$57.36	$95.31
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.88 / $100.00 / $949.44	Facility	26	$34.88	$100.00	$949.44
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $25.73 / $65.37 / $2,162.39	Facility	26	$25.73	$65.37	$2,162.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $40.67 / $51.37 / $52.93	Facility	26	$40.67	$51.37	$52.93
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $34.88 / $34.88 / $35.65	Facility	26	$34.88	$34.88	$35.65
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