Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.52 / $46.13 / $76.28	Facility	26	$23.52	$46.13	$76.28
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.88 / $100.00 / $731.61	Facility	26	$27.88	$100.00	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $20.46 / $51.85 / $1,678.39	Facility	26	$20.46	$51.85	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $32.83 / $40.86 / $42.21	Facility	26	$32.83	$40.86	$42.21
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $27.88 / $27.88 / $28.09	Facility	26	$27.88	$27.88	$28.09
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