Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.37 / $102.74 / $178.87	Facility	26	$52.37	$102.74	$178.87
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $62.97 / $97.35 / $2,533.52	Facility	26	$62.97	$97.35	$2,533.52
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $48.36 / $119.92 / $5,739.12	Facility	26	$48.36	$119.92	$5,739.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $75.84 / $91.19 / $99.16	Facility	26	$75.84	$91.19	$99.16
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $62.97 / $62.97 / $63.07	Facility	26	$62.97	$62.97	$63.07
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $2,533.52 / $2,533.52 / $4,053.27	Facility	26	$2,533.52	$2,533.52	$4,053.27