Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.84 / $51.51 / $81.02	Facility	26	$25.84	$51.51	$81.02
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $30.80 / $100.00 / $731.61	Facility	26	$30.80	$100.00	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $22.32 / $56.09 / $1,678.39	Facility	26	$22.32	$56.09	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $32.83 / $44.89 / $46.24	Facility	26	$32.83	$44.89	$46.24
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $30.80 / $30.80 / $31.08	Facility	26	$30.80	$30.80	$31.08
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