Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.98 / $154.52 / $265.01	Facility	26	$78.98	$154.52	$265.01
Asuris Northwest Health Facility/Professional Facility Modifier 26 Low / Median / High Price $95.51 / $660.96 / $2,533.52	Facility	26	$95.51	$660.96	$2,533.52
Kaiser Permanente Facility/Professional Facility Modifier 26 Low / Median / High Price $70.98 / $178.36 / $5,739.12	Facility	26	$70.98	$178.36	$5,739.12
Pacific Source Facility/Professional Facility Modifier 26 Low / Median / High Price $114.95 / $139.46 / $146.90	Facility	26	$114.95	$139.46	$146.90
Premera BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $95.51 / $95.51 / $125.00	Facility	26	$95.51	$95.51	$125.00
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