Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.50 / $74.94 / $136.69	Facility	26	$38.50	$74.94	$136.69
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $45.30 / $100.00 / $731.61	Facility	26	$45.30	$100.00	$731.61
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $36.58 / $88.74 / $1,678.39	Facility	26	$36.58	$88.74	$1,678.39
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $54.96 / $66.06 / $76.16	Facility	26	$54.96	$66.06	$76.16
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $45.30 / $45.30 / $45.70	Facility	26	$45.30	$45.30	$45.70
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